Impact of malnourishment on the pharmacokinetics of acetaminophen and susceptibility to acetaminophen hepatotoxicity Article Swipe
Daan Zillen
,
Kris L. L. Movig
,
Gert D. Kant
,
Joost B. Masselink
,
Paola Mian
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1002/ccr3.4611
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1002/ccr3.4611
Background Acetaminophen hepatotoxicity is thought to be primarily caused by formation of the specific reactive metabolite N‐acetyl‐para‐benzo‐quinone imine (NAPQI). Malnourished individuals are at increased risk of acetaminophen‐related hepatotoxicity. We report a case of low acetaminophen clearance in a severely underweight young woman, and elaborate on the possible effects of malnutrition on the total clearance of acetaminophen as well as on the separate contributions of the different metabolic pathways. Case report An 18‐year‐old Caucasian woman weighing 43 kg with a history of eating disorder‐related hospital admissions presented at the emergency department after having ingested 33 tablets of acetaminophen 500 mg two hours earlier. She then received intravenous N‐acetylcysteine for 33 h. Nine hours after ingestion, the acetaminophen elimination half‐life (t½) was estimated to be >100 h. Discussion While decreased total acetaminophen clearance (twofold) due to malnutrition has been reported in literature, the extremely low clearance in this specific patient cannot be explained. Malnourished individuals generally have reduced antioxidant reserves, coinciding with a shift in metabolic routes toward oxidative metabolism. This may result in increased formation of NAPQI and reduced neutralizing capacity, thereby increasing the risk of acetaminophen‐induced hepatotoxicity. Evidence for this observation can be found in animal and to a lesser extent in human studies.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/ccr3.4611
- OA Status
- gold
- Cited By
- 5
- References
- 32
- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3211878941Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/ccr3.4611Digital Object Identifier
- Title
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Impact of malnourishment on the pharmacokinetics of acetaminophen and susceptibility to acetaminophen hepatotoxicityWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2021Year of publication
- Publication date
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2021-11-01Full publication date if available
- Authors
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Daan Zillen, Kris L. L. Movig, Gert D. Kant, Joost B. Masselink, Paola MianList of authors in order
- Landing page
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https://doi.org/10.1002/ccr3.4611Publisher landing page
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
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https://doi.org/10.1002/ccr3.4611Direct OA link when available
- Concepts
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Acetaminophen, Medicine, Acetylcysteine, Pharmacokinetics, acetaminophen overdose, Ingestion, Metabolite, Malnutrition, Pharmacology, Anesthesia, Physiology, Internal medicine, Antioxidant, Chemistry, BiochemistryTop concepts (fields/topics) attached by OpenAlex
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5Total citation count in OpenAlex
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2025: 2, 2024: 1, 2023: 1, 2021: 1Per-year citation counts (last 5 years)
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32Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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