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Cited by 528Drug-Induced Hepatotoxicity and ProtectionPoisoning and overdose treatmentsParaquat toxicity studies and treatments

Acute liver necrosis following overdose of paracetamol

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Davidson, D. G., Eastham, W. N.·1966·BMJ
DOI 10.1136/bmj.2.5512.497PMC PMC1943529
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Abstract

Although paracetamol was first described more than seventy years ago, it is only in the last fifteen that it has become popular as a mild analgesic.It has been shown to be the principal breakdown product of phenacetin and to have an analgesic effect of similar magnitude.Liver damage following abuse of phenacetin is quoted by Kasanen and Forsstrom (1964), but in humans this complication has not been noted with paracetamol, although liver necrosis has been reported in rats (Boyd and Bereczky, 1966).Case 1 A woman aged 30, an inmate of a mental institution, was admitted to hospital two hours after ingesting at least 50 paracetamol tablets.She had been discovered while still swallowing some of the drug, and gastric lavage was carried out almost immediately.She had been under psychiatric care since adolescence and had received various drug therapies.Currently she was taking nortriptyline, 25 mg.three times a day.She had been taking barbiturates as hypnotics for many years.In the past she had been treated with chlorpromazine and amitriptyline.On examination she was apyrexial, and was drowsy but easily roused to answer questions.There was no evidence of icterus and no hyperventilation.The pulse rate was 80 and B.P. 90/70 mm.Hg.The liver was not palpable.Apart from the diminished level of consciousness there was no evidence of a neurological lesion.Results of investigations are given in Table I.

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  • APAP overdose is a common cause of acute liver failure in the US.

    “APAP overdose is a common cause of acute liver failure in the US [71,72].”

    From A liver-on-a-chip platform with bioprinted hepatic spheroids (2016) · cites this paper as [72]

    The Summary (page unavailable) describes two fatal cases of acute liver necrosis after paracetamol overdose and suggests paracetamol was the chief cause. The paper does not establish that overdose is a common cause of acute liver failure in the US; it provides no US frequency data. (LLM, conf=0.88)

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  1. [1]1. on 17 August 2023 by guest. Protected by copyright. http://www.bmj.com/ Br Med J: first published as 10.1136/bmj.2.5512.497 on 27 August 1966. Downloaded from REFERENCES Amer. 7. Med., 1955, 19, 163.
  2. [10]10. Werner, G. (1962). Clin. Pharmacol. Ther., 3, 59. on 17 August 2023 by guest. Protected by copyright. http://www.bmj.com/ Br Med J: first published as 10.1136/bmj.2.5512.497 on 27 August 1966. Downloaded from

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Authors
Davidson, D. G., & Eastham, W. N.
Venue
BMJ
Publisher
BMJ
Published
1966-08-27
Volume
2
Issue
5512
Pages
497-499
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.2.5512.497
PMC
PMC1943529
OpenAlex
W2067245473
Cited by
528
References
7
Citations by year
2026: 4 · 2025: 9 · 2024: 15 · 2023: 12 · 2022: 13 · 2021: 10 · 2020: 13 · 2019: 10 · 2018: 10 · 2017: 13 · 2016: 26 · 2015: 20 · 2014: 14 · 2013: 9 · 2012: 14
FWCI
5.44
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
  • Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
  • Health Sciences › Medicine › Surgery › Paraquat toxicity studies and treatments
Keywords
acetaminophen overdose, acute liver necrosis, hepatotoxicity, drug poisoning, psychiatric patients, nortriptyline, barbiturates, gastric lavage, phenacetin
MeSH terms
Acetaminophen, Adult, Female, Humans, Hypoglycemia, Male, Necrosis, Chemical and Drug Induced Liver Injury

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