| Title | Delayed toxic acetaminophen level after initial four hour nontoxic level. | | Author(s) | Tighe TV, Walter FG | | Institution | Valley Medical Center, University of California, San Francisco, School of Medicine, Department of Emergency Medicine, Fresno 93702. | | Source | J Toxicol Clin Toxicol 1994; 32(4):431-4. | | MeSH | Acetaminophen
Acetylcysteine
Adult
Female
Humans
Naproxen
Overdose
Propoxyphene
Time Factors
| | Abstract | Antidotal therapy for acetaminophen poisoning is routinely based on a single acetaminophen level obtained four or more hours after ingestion. Some experts recommend additional acetaminophen levels if there are coingestants. This case report describes a 20-year-old woman who ingested acetaminophen 13 g, propoxyphene napsylate 2 g and naproxen sodium 3.75 g. A 4.5 h acetaminophen level was 83.5 mg/L (nontoxic). A 6.75 h acetaminophen level was 124.6 mg/L (toxic). The patient was treated with N-acetylcysteine and recovered without sequelae. This is the first published report of a delayed toxic acetaminophen level occurring after an initial nontoxic level. Although rare, the possibility of a delayed peak acetaminophen level merits consideration, particularly with coingestions that delay gastric emptying. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
| | PubMed ID | 7914547 |
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