| Title |
A review of the evidence concerning hepatic glutathione depletion and susceptibility to hepatotoxicity after paracetamol overdose
|
|---|---|
| Published in |
Open access emergency medicine OAEM, December 2011
|
| DOI | 10.2147/oaem.s24963 |
| Pubmed ID | |
| Authors |
David Wood, Kalsi, W. Stephen Waring, David Wood, Paul Dargan |
| Abstract |
Paracetamol (acetaminophen) poisoning is common throughout the world. The management of nonstaggered (acute) paracetamol overdose is based on the plasma paracetamol concentration plotted on a treatment nomogram. In the UK there are two treatment lines on this nomogram, with the lower treatment line used for individuals felt to be at 'high risk' of paracetamol-related hepatotoxicity either as a result of induction of cytochrome P450 isoenzymes or reduction of intrahepatic glutathione. In this article we review the risk factors that, in current guidelines, are felt to increase risk due to a reduction in intrahepatic glutathione concentrations. Based on our review of the published literature, we feel that cystic fibrosis, acute viral illness, malnutrition, and eating disorders such as anorexia nervosa are likely to be associated with reduction in intrahepatic glutathione concentrations, and that this risk is likely to be related to malnutrition secondary to the disease. Chronic hepatitis C infection is also associated with reduced glutathione concentrations, although this appears to be independent of any associated malnutrition. Ageing and acute fasting are not associated with an increased risk of paracetamol-related hepatotoxicity due to reductions in glutathione concentrations. Finally, the evidence for HIV infection is inconclusive, particularly as the majority of studies were conducted in the pre-anti-viral treatment (HAART) era; however it is likely that patients with symptomatic HIV/AIDS have reduced glutathione concentrations due to associated malnutrition. Although there have been few studies which have specifically investigated whether there is an association between reduced intrahepatic glutathione concentrations and increased risk of paracetamol-related hepatotoxicity, in our opinion, it is likely that the above conditions that are associated with reduced glutathione concentrations, will be associated with an increased risk of paracetamol-related hepatotoxicity. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Finland | 1 | 14% |
| Canada | 1 | 14% |
| Unknown | 5 | 71% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 86% |
| Practitioners (doctors, other healthcare professionals) | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 78 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 3% |
| India | 1 | 1% |
| Unknown | 75 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 15 | 19% |
| Student > Master | 12 | 15% |
| Student > Ph. D. Student | 8 | 10% |
| Researcher | 6 | 8% |
| Unspecified | 4 | 5% |
| Other | 16 | 21% |
| Unknown | 17 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 27 | 35% |
| Agricultural and Biological Sciences | 6 | 8% |
| Biochemistry, Genetics and Molecular Biology | 5 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 6% |
| Unspecified | 4 | 5% |
| Other | 12 | 15% |
| Unknown | 19 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 June 2022.
All research outputs
#3,218,136
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Outputs from Open access emergency medicine OAEM
#24
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#23,697
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Outputs of similar age from Open access emergency medicine OAEM
#1
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