Serum acetaminophen concentrations after acute overdose are not altered by opioid co-ingestion

Waring, W. Stephen; Benhalim, Suzanne
December 2008
Journal of Toxicological Sciences;Dec2008, Vol. 33 Issue 5, p549
Academic Journal
Serum acetaminophen concentrations are of critical importance in determining the need for acetylcysteine therapy after acute acetaminophen overdose. Limited data suggest opioid co-ingestion might alter acetaminophen pharmacokinetics. The present study was designed to examine serum acetaminophen concentrations after acute overdose, and to compare between patients that co-ingested an opioid and those that did not. A prospective study of consecutive patients that presented to hospital within 16 hr of acute acetaminophen overdose. Equivalent 4-hr acetaminophen concentrations were calculated using the serum acetaminophen concentration at a fixed interval 3 to 16 hr after ingestion. Groups were compared using Mann Whitney tests. There were 990 patients; 295 (29.8%) had co-ingested an opioid, and 695 had not. The median (interquartile range) stated dose was 10 g (6-16 g) vs. 10 g (7-16 g) respectively (P = 0.94), interval between ingestion and acetaminophen determination was 4.5 hr (4.0-6.0 hr) vs. 4.5 hr (4.0-5.5 hr) respectively (P = 0.41), and serum acetaminophen concentration was 56 mg/l (24-105 mg/l) va. 60 mg/l (23-129 mg/l) respectively (P = 0.25). A positive relationship was noted between stated dose and equivalent 4-hr serum acetaminophen concentration, but did not differ between groups. The acetaminophen dose-concentration relationship was similar in patients that did and did not co-ingest an opioid. Therefore, early serum acetaminophen concentrations can be used to determine the extent of drug exposure, irrespective of whether an opioid has been co-ingested.


Related Articles

  • Correction.  // Minnesota Medicine;May2013, Vol. 96 Issue 5, p5 

    A correction to the article "The Opioid Crisis" that was published in the March 2013 issue is presented.

  • Opioid Overdose: When Good Drugs Break Bad. Berge, Keith H.; Burkle, Christopher M. // Mayo Clinic Proceedings;Apr2014, Vol. 89 Issue 4, p437 

    An introduction is presented in which the editor discusses various reports within the issue on topics including overdose (OD) of opioid, drug abuse and laws defining the use of opioid in the U.S.

  • The Contribution of Patient Satisfaction to the Opiate Abuse Epidemic. Hirsch, Ronald Lauren // Mayo Clinic Proceedings;Aug2014, Vol. 89 Issue 8, p1168 

    A letter to the editor is presented in response to the article "Opioid Overdose: When Good Drugs Break Bad," by K. H. Berge et al. in the 2014 issue.

  • In reply--The Contribution of Patient Satisfaction to the Opiate Abuse Epidemic. Berge, Keith H.; Burkle, Christopher M. // Mayo Clinic Proceedings;Aug2014, Vol. 89 Issue 8, p1168 

    A response from the article "Opioid Overdose: When Good Drugs Break Bad," in the 2014 issue is presented.

  • Erratum.  // MMWR: Morbidity & Mortality Weekly Report;1/13/2017, Vol. 66 Issue 1, p35 

    Corrections to the article "Increases in Drug and Opioid-Involved Overdose Deaths: United States, 2010-2015" in Vol. 65, Nos. 50 & 51 are presented.

  • Preventing opioid overdoses in Europe: a critical assessment of known risk factors and preventative measures. Giraudon, Isabelle; Vicente, Juli├ín // Drugnet Europe;Oct-Dec2012, Issue 80, p7 

    The article offers information on a study linking risk factors to opioid overdoses and the measures to be considered to lessen fatal outcomes.

  • Discontinuing prescribed opioids reduces repeat overdoses.  // Reactions Weekly;1/16/2016, Vol. 1584 Issue 1, p7 

    An abstract of the article "Opioid Prescribing After Nonfatal Overdose and Association With Repeated Overdose: A Cohort Study" by M.R. Larochelle published in the January 2016 issue of the journal "Annals of Internal Medicine" is presented.

  • CDC: Majority of overdose deaths are opioid-related. Krisberg, Kim // Nation's Health;Mar2016, Vol. 46 Issue 2, p8 

    The article reports on research results indicating the association of overdose mortality with opioid abuse in the U.S. in December 2015.

  • Startup-led team wins FDA opioid overdose app contest. Slabodkin, Greg // Healthdatamanagement.com;12/19/2016, p1 

    OD Help aids opioid overdose victims find those carrying the naloxone antidote, says Peter Lurie.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics