C. Ulmeanu *, D. Orășeanu *, Viorela Gîrniță *, I. Ciubotaru *
* Conf. dr. Ulmeanu Coriolan, Conf. dr. Oriășeanu Dumitru, Dr. Gîrniță Viorela, Dr. Ciubotaru Ionuț – Departamentul de Toxicologie al Spitalului Clinic Central de Copii
Abstract
Introduction: Acetaminophen is the most frequently used drug for the treatment of fever in pediatrics. In Romania there are more than 100 products that include acetaminophen. Last years the number of patients with acetaminophen poisoning increased. Objectives: 1. to measure the plasma acetaminophen concentrations at 4, 10 and 15 hours post ingestion; 2. to observe how many hours after ingestion the hepatotoxicity occurs (elevated serum levels of alanine and aspartate transaminase, total bilirubin levels, prolonged prothrombin time); 3. to define risk groups according to initial plasma acetaminophen concentrations. Material and methods: We studied 25 patients with acetaminophen poisoning. We measured in all patients the plasma acetaminophen concentration at 4 hours after ingestion. The treatment with N-acetylcysteine was instituted according with the plasma acetaminophen concentration. In some cases we could not use the criteria of the acetaminophen plasmatic level. Conlcuslons: In Romania it is not possible to manage acetaminophen poisoning according to the plasma acetaminophen concentration.In this situation we recommend to start the treatment with N-acetylcysteine per os if the patient ingested more than 80 mg/kg acetaminophen. We must not wait for 24 hours the onset of the simptomatology in order to initiate the treatment with N.A.C.