![]() ![]() ![]() Our study spans cases from 2017 to 2019 encountered at free-standing pediatric and adult tertiary care hospitals within the same medical center. Here we present a case series of patients treated with fomepizole for persistently elevated APAP concentrations who sustained no substantial liver injury. The role of fomepizole as an inhibitor of CYP2E1 to reduce the conversion of APAP to NAPQI has been postulated and studied in animal models as well as human hepatocytes, however there are limited clinical data. The kinetics and metabolism of fomepizole has also been well studied. Fomepizole issafey and effective in humans for inhibition of alcohol dehydrogenase in toxic alcohol and glycol ingestion. įomepizole is a potent inhibitor of CYP2E1. This may exceed 5% of cases in some reports of early administration 8 h post ingestion. Additionally, there are reports of hepatotoxicity despite early use of IV NAC. Standard therapy with IV N-acetylcysteine (NAC) is effective in most cases although higher doses may be necessary for larger ingestions. Acetaminophen overdose may overwhelm normal detoxification pathways ed, and the conversion of APAP to NAPQI by CYP2E1 drives hepatotoxicity, which we define here as elevations in ALT greater than 5 times the upper limit of normal for our reference laboratory (>230 U/L). After therapeutic dosing, approximately 5% of APAP undergoes metabolism by cytochrome P450 2E1 (CYP2E1) to N-Acetyl-p-benzoquinone imine (NAPQI), a highly hepatotoxic metabolite. Its toxicity is a common cause of acute liver failure in the United States. Acetaminophen (APAP) is a commonly used analgesic and antipyretic. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |