Articles: acetaminophen.
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Ann. Clin. Biochem. · Nov 1984
Case ReportsAspirin metabolites causing misinterpretation of paracetamol results.
The inadequacy of single, simple arithmetic corrections for salicylate interference in the widely employed Glynn and Kendal technique for plasma paracetamol assay is highlighted by reference to an actual case of combined salicylate/paracetamol intoxication in an infant. Attention is drawn for the first time to the not insubstantial contribution to such interference made by even the minor metabolites of salicylate. The conclusion is reached that is necessary, particularly in the assessment of paracetamol toxicity, to determine the presence of salicylate, and when present, to employ a specific method for the estimation of paracetamol.
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A high-performance liquid chromatographic (HPLC) method has been developed for the quantitation of acetaminophen, chlorpheniramine maleate, dextromethorphan hydrobromide, and phenylpropanolamine hydrochloride in combination in pharmaceutical dosage forms using a single column and three different mobile phases. The method developed is sensitive for the content uniformity test for tablets. No preliminary extraction procedure is required for liquid preparation and a very simple extraction procedure is required for tablets. The method is accurate and precise with RSD (based on five injections) of 1.2, 2.4, 1.9, and 1.6% for acetaminophen, chlorpheniramine, dextromethorphan, and phenylpropanolamine, respectively.
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Two case reports of patients with anion gap metabolic lactic acidosis and hypoglycemia are presented. Both patients subsequently died of acute liver failure secondary to acetaminophen hepatotoxicity. The development of type B lactic acidosis with hypoglycemia might have been caused by a deficit in gluconeogenesis secondary to severe hepatic failure and/or a toxic metabolite of acetaminophen. Our findings suggest that acetaminophen toxicity should be considered when lactic acidosis and hypoglycemia are seen.
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Eur. J. Clin. Pharmacol. · Jan 1984
Randomized Controlled Trial Comparative Study Clinical TrialComparison of a traditional paracetamol medication and a new paracetamol/paracetamol-methionine ester combination.
The SUR 2647 combination is a sachet formulation containing free paracetamol and its N-acetyl-methionate ester (SUR 2647). In a randomized, single-blind, between-patient study the onset of analgesia, duration and efficacy of the SUR 2647 combination vs paracetamol was investigated in out-patients after oral surgery. One group (n = 27) received sachets of SUR 2647 combination 2 b.i.d. (equivalent to 2 g paracetamol X 2) on the day of operation, and one sachet b.i.d. (equivalent to 1 g paracetamol X 2) for the following two days. ⋯ Mean pain scores showed that the SUR 2647 combination regime reduced pain significantly more than the paracetamol regime from 0.5 to 3.0 h after initiation of medication. The mean pain scores did not show a significant difference during the remaining observation period. Mild to moderate drowsiness was reported in both treatment groups, but it was more common in subjects given SUR 2647 combination.