Acetaminophen

Pathology and clinical presentation of hepatotoxicity

William M Lee, George Ostapowicz

Research output: Chapter in Book/Report/Conference proceedingChapter

5 Citations (Scopus)

Abstract

Acetaminophen (called paracetamol outside the United States) is a popular and widely used analgesic and antipyretic agent. First synthesized in 1893, it was introduced for prescription use in the United States in 1955 and approved for over-the-counter use in 1960 (1). It is frequently combined with codeine or other analgesic agents, decongestants, and antihistamines. Over 300 different preparations are now available in the United States with more than one billion pills sold annually. Acetaminophen’s popularity has in part arisen from its apparent lack of side effects. Unlike aspirin and other nonsteroidal anti-inflammatory drugs, it does not cause gastric inflammation, ulcers, or coronary ischemia. Although it is remarkably safe when used at usual therapeutic doses, it has a relatively narrow therapeutic window. Acetaminophen overdose is the leading cause for calls to Poison Control Centers (O100,000/yr), and accounts for more than 56,000 emergency room visits, 2600 hospitalizations and an estimated 458 deaths due to acute liver failure (ALF) each year (1). Data from the U.S. Acute Liver Failure Study Group registry of more than 1100 patients with acute liver failure (ALF) from across the United States, suggests that acetaminophen poisoning alone currently constitutes nearly 50% of all ALF [Fig. 1; (2)]. Available in single or combination products, acetaminophen produces more than a billion dollars in annual sales and is heavily marketed for its safety compared to nonsteroidal analgesics. By enabling self-diagnosis and treatment of minor aches and pains, its benefits are said by the United States Food and Drug Administration (FDA) to outweigh its risks (3).

Original languageEnglish (US)
Title of host publicationDrug-Induced Liver Disease, Second Edition
PublisherCRC Press
Pages389-405
Number of pages17
ISBN (Electronic)9781420021141
ISBN (Print)9780849398964
StatePublished - Jan 1 2007

Fingerprint

Clinical Pathology
Acetaminophen
Acute Liver Failure
Analgesics
Poison Control Centers
Nasal Decongestants
Pain
Codeine
Antipyretics
Histamine Antagonists
United States Food and Drug Administration
Stomach Ulcer
Poisoning
Aspirin
Prescriptions
Registries
Hospital Emergency Service
Hospitalization
Anti-Inflammatory Agents
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Lee, W. M., & Ostapowicz, G. (2007). Acetaminophen: Pathology and clinical presentation of hepatotoxicity. In Drug-Induced Liver Disease, Second Edition (pp. 389-405). CRC Press.

Acetaminophen : Pathology and clinical presentation of hepatotoxicity. / Lee, William M; Ostapowicz, George.

Drug-Induced Liver Disease, Second Edition. CRC Press, 2007. p. 389-405.

Research output: Chapter in Book/Report/Conference proceedingChapter

Lee, WM & Ostapowicz, G 2007, Acetaminophen: Pathology and clinical presentation of hepatotoxicity. in Drug-Induced Liver Disease, Second Edition. CRC Press, pp. 389-405.
Lee WM, Ostapowicz G. Acetaminophen: Pathology and clinical presentation of hepatotoxicity. In Drug-Induced Liver Disease, Second Edition. CRC Press. 2007. p. 389-405
Lee, William M ; Ostapowicz, George. / Acetaminophen : Pathology and clinical presentation of hepatotoxicity. Drug-Induced Liver Disease, Second Edition. CRC Press, 2007. pp. 389-405
@inbook{b5b1006771a942a29248d20fdab6d4c6,
title = "Acetaminophen: Pathology and clinical presentation of hepatotoxicity",
abstract = "Acetaminophen (called paracetamol outside the United States) is a popular and widely used analgesic and antipyretic agent. First synthesized in 1893, it was introduced for prescription use in the United States in 1955 and approved for over-the-counter use in 1960 (1). It is frequently combined with codeine or other analgesic agents, decongestants, and antihistamines. Over 300 different preparations are now available in the United States with more than one billion pills sold annually. Acetaminophen’s popularity has in part arisen from its apparent lack of side effects. Unlike aspirin and other nonsteroidal anti-inflammatory drugs, it does not cause gastric inflammation, ulcers, or coronary ischemia. Although it is remarkably safe when used at usual therapeutic doses, it has a relatively narrow therapeutic window. Acetaminophen overdose is the leading cause for calls to Poison Control Centers (O100,000/yr), and accounts for more than 56,000 emergency room visits, 2600 hospitalizations and an estimated 458 deaths due to acute liver failure (ALF) each year (1). Data from the U.S. Acute Liver Failure Study Group registry of more than 1100 patients with acute liver failure (ALF) from across the United States, suggests that acetaminophen poisoning alone currently constitutes nearly 50{\%} of all ALF [Fig. 1; (2)]. Available in single or combination products, acetaminophen produces more than a billion dollars in annual sales and is heavily marketed for its safety compared to nonsteroidal analgesics. By enabling self-diagnosis and treatment of minor aches and pains, its benefits are said by the United States Food and Drug Administration (FDA) to outweigh its risks (3).",
author = "Lee, {William M} and George Ostapowicz",
year = "2007",
month = "1",
day = "1",
language = "English (US)",
isbn = "9780849398964",
pages = "389--405",
booktitle = "Drug-Induced Liver Disease, Second Edition",
publisher = "CRC Press",

}

TY - CHAP

T1 - Acetaminophen

T2 - Pathology and clinical presentation of hepatotoxicity

AU - Lee, William M

AU - Ostapowicz, George

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Acetaminophen (called paracetamol outside the United States) is a popular and widely used analgesic and antipyretic agent. First synthesized in 1893, it was introduced for prescription use in the United States in 1955 and approved for over-the-counter use in 1960 (1). It is frequently combined with codeine or other analgesic agents, decongestants, and antihistamines. Over 300 different preparations are now available in the United States with more than one billion pills sold annually. Acetaminophen’s popularity has in part arisen from its apparent lack of side effects. Unlike aspirin and other nonsteroidal anti-inflammatory drugs, it does not cause gastric inflammation, ulcers, or coronary ischemia. Although it is remarkably safe when used at usual therapeutic doses, it has a relatively narrow therapeutic window. Acetaminophen overdose is the leading cause for calls to Poison Control Centers (O100,000/yr), and accounts for more than 56,000 emergency room visits, 2600 hospitalizations and an estimated 458 deaths due to acute liver failure (ALF) each year (1). Data from the U.S. Acute Liver Failure Study Group registry of more than 1100 patients with acute liver failure (ALF) from across the United States, suggests that acetaminophen poisoning alone currently constitutes nearly 50% of all ALF [Fig. 1; (2)]. Available in single or combination products, acetaminophen produces more than a billion dollars in annual sales and is heavily marketed for its safety compared to nonsteroidal analgesics. By enabling self-diagnosis and treatment of minor aches and pains, its benefits are said by the United States Food and Drug Administration (FDA) to outweigh its risks (3).

AB - Acetaminophen (called paracetamol outside the United States) is a popular and widely used analgesic and antipyretic agent. First synthesized in 1893, it was introduced for prescription use in the United States in 1955 and approved for over-the-counter use in 1960 (1). It is frequently combined with codeine or other analgesic agents, decongestants, and antihistamines. Over 300 different preparations are now available in the United States with more than one billion pills sold annually. Acetaminophen’s popularity has in part arisen from its apparent lack of side effects. Unlike aspirin and other nonsteroidal anti-inflammatory drugs, it does not cause gastric inflammation, ulcers, or coronary ischemia. Although it is remarkably safe when used at usual therapeutic doses, it has a relatively narrow therapeutic window. Acetaminophen overdose is the leading cause for calls to Poison Control Centers (O100,000/yr), and accounts for more than 56,000 emergency room visits, 2600 hospitalizations and an estimated 458 deaths due to acute liver failure (ALF) each year (1). Data from the U.S. Acute Liver Failure Study Group registry of more than 1100 patients with acute liver failure (ALF) from across the United States, suggests that acetaminophen poisoning alone currently constitutes nearly 50% of all ALF [Fig. 1; (2)]. Available in single or combination products, acetaminophen produces more than a billion dollars in annual sales and is heavily marketed for its safety compared to nonsteroidal analgesics. By enabling self-diagnosis and treatment of minor aches and pains, its benefits are said by the United States Food and Drug Administration (FDA) to outweigh its risks (3).

UR - http://www.scopus.com/inward/record.url?scp=84882528592&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84882528592&partnerID=8YFLogxK

M3 - Chapter

SN - 9780849398964

SP - 389

EP - 405

BT - Drug-Induced Liver Disease, Second Edition

PB - CRC Press

ER -