Chronic ethanol use and acute acetaminophen overdose toxicity

Q: History of chronic alcoholism increases the chances of acetaminophen hераtοtοхicity.

A) True

B) False

Answer: B

It may seem logical that chronic alcohol abuse should increase the risk of developing hераtοtοxiсitу due to an acute overdose of acetaminophen. Still, if treated appropriately, the outcome is same. If the acetylcysteine is administrated within eight hours of ingestion or with аϲеtаmiոοрheո per the original Rumack-Matthew nomogram, the outcome is similar.

Although it sounds like a paradox, this is due to a completely different pathway of liver injury via alcohol and acetaminophen.

#toxicity

References:

1. Makin AJ, Wendon J, Williams R. A 7-year experience of severe acetaminophen-induced hepatotoxicity (1987-1993). Gastroenterology 1995; 109:1907.

2. Hendrickson RG, McKeown NJ. Acetaminophen. In: Goldfrank's Toxicologic Emergencies, 11th edition, Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS (Eds), McGraw-Hill Education, 2019. p.472.

3. Smilkstein, MJ. Chronic ethanol use and acute acetaminophen overdose toxicity. J Toxicol Clin Toxicol 1998; 36:476.