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Patterns of acetaminophen use in alcoholic patients
C F Seifert1, D S Lucas, T G Vondracek
1Section of Pharmacy Practice, College of Pharmacy, University of Oklahoma, Oklahoma City.
Pharmacotherapy
|July 1, 1993
Summary
Alcoholics may face higher liver damage risk from acetaminophen due to altered metabolism. About 31% of alcoholics regularly use acetaminophen, with 10% abusing it, increasing hepatotoxicity concerns.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Addiction Medicine
Background:
- Alcoholics exhibit altered cytochrome P-450 activity and reduced hepatic glutathione, potentially increasing susceptibility to acetaminophen-induced liver injury.
- Existing data on acetaminophen use patterns among alcoholics are limited to scattered case reports.
Purpose of the Study:
- To investigate the frequency and patterns of acetaminophen consumption in individuals with alcohol use disorders.
- To identify subgroups of alcoholics with specific acetaminophen use behaviors that may elevate hepatotoxicity risk.
Main Methods:
- A detailed ethanol and drug history was collected from 64 patients identified using the CAGE questionnaire.
- Patients were categorized based on acetaminophen use: nonusers, as-needed users, and regular users (further classified by frequency and dosage).
Main Results:
- 50% of the alcohol-dependent patients were nonusers of acetaminophen.
- 31% of alcoholics reported regular acetaminophen use, with 10% classified as abusers (>4 g/day).
- Approximately 4.7% of the interviewed alcoholics exhibited drinking and acetaminophen use patterns associated with increased hepatotoxicity risk.
Conclusions:
- A significant proportion of alcoholics use acetaminophen regularly, with a notable percentage abusing the drug, highlighting a potential public health concern.
- While most alcoholics do not use acetaminophen, specific use patterns among users warrant further investigation regarding hepatotoxicity.
- The study identifies a small but clinically relevant subgroup of alcoholics with concerning acetaminophen use patterns that may predispose them to liver damage.