Treatment nomograms are used in paracetamol poisoning for indicating when antidotes should be given to prevent hepatic or renal damage.1 We report a fatal case of paracetamol poisoning in an epileptic taking phenytoin, in whom no antidotal treatment was given because it was not indicated.
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References
1.
Prescott LF, Park J., Sutherland GR, Smith IJ & Proudfoot ATCysteamine, methionine and penicillamine in the treatment of paracetamol poisoning . Lancet1976; ii: 109-13.
2.
Miner DJ & Kissinger PTEvidence for the involvement of N-acetyl quinoneimine in acetaminophen metabolism . Biochemical Pharmacology1979; 28: 3285-90.
3.
Jollow DJ, Mitchell JR, Potter WZ, Davis DC, Gillette JR & Brodie BBAcetaminophen-induced hepatic necrosis. II. Role of covalent binding in vivo . Journal of Pharmacology and Experimental Therapeutics1973; 187: 195-202.
4.
Devalia JL, Ogilvie RC & McLean Aem.Dissociation of cell death from covalent binding of paracetamol by flavones in a hepatocyte system. Biochemical Pharmacology1982; 31: 3745-9.
5.
Mitchell JR, Jollow DJ, Potter WZ, Gillette JR & Brodie BBAcetaminophen-induced hepatic necrosis. IV. Protective role of glutathione . Journal of Pharmacology and Experimental Therapeutics1973; 187: 211-7.
6.
Prescott LF, Illingworth RN, Critchley Jajh, Stewart MJ, Adam RD & Proudfoot ATIntravenous N-acetylcysteine: the treatment of choice for paracetamol poisoning . British Medical Journal1979; ii: 1097-100.
7.
Vale JA, Meredith TJ & Goulding R.Treatment acetaminophen poisoning. The use of oral methionineArchives of Internal Medicine1981; 141: 394-6.
8.
Vina J., Romero FJ, Estrela JM & Vina JREffect acetaminophen (paracetamol) and its antagonists o glutathione (GSH) content in rat liver. Biochemic Pharmacology1980; 29: 1968-70.
9.
Wright N. & Prescott LFPotentiation by previous dru therapy of hepatotoxicity following paracetamol over dosage. Scottish Medical Journal1973 ; 18: 56-8.
10.
McClain CJ, Kromhout JP, Peterson FJ & Holtzman JLPotentiation of acetaminophen toxicity by alcoho. Journal of the American Medical Association1980; 244251-3.
11.
Lesser PB, Vietti MM & Clark WDLethal enhance ment of therapeutic doses of acetaminophen by alcoholDigestive Diseases and Science1986; 31: 103-5.
12.
Smith Jae, Hine ID, Beck P. & Routledge PAPara cetamol toxicity: is enzyme induction important?Huma, Toxicology1986; 5: 383-5.
