Impaired absorption of paracetamol in vegetarians.

Prescott, L. F.; Yoovathaworn, Krongtong; Makarananda, Kittima; Saivises, R; Sriwatanakul, Kampon

doi:10.1111/j.1365-2125.1993.tb04223.x

Cited by 16 publications

(9 citation statements)

References 20 publications

(36 reference statements)

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“…In the present study, the pharmacokinetic parameters (Cmax, tmax, Vz/f and CL/f) of paracetamol for the patients during convalescence are similar to those reported previously in healthy Thai subjects [20]. However, the mean urinary excretion of paracetamol glucuronide and paracetamol sulphate in this study are closer to values in healthy Caucasians [18].…”

Section: Discussionsupporting

confidence: 90%

Paracetamol disposition in Thai patients during and after treatment of falciparum malaria

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Edwards

et al. 1995

Eur J Clin Pharmacol

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Investigations in animals have suggested that conjugation of paracetamol may be reduced in malaria. We have measured plasma concentrations and the urinary excretion of paracetamol and its phase II metabolites in eight Thai patients during uncomplicated falciparum malaria and in convalescence, following a 1000 mg single oral dose. The apparent oral clearance (Malaria, 3.6; Convalescence, 3.9; ml.min-1.kg-1), the elimination half-life (Malaria, 3.8; Convalescence, 3.7 h) and apparent volume of distribution (Malaria, 1.2; Convalescence, 1.2; l.kg-1) of paracetamol were similar during malaria and convalescence. In addition, the urinary excretion of paracetamol and its major phase II metabolites and their formation clearances from paracetamol were not significantly different between the two study phases. These data show that clinical malaria infection has no effect on the conjugation of paracetamol in man.

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Section: Discussionsupporting

confidence: 90%

Paracetamol disposition in Thai patients during and after treatment of falciparum malaria

Ismail

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Edwards

et al. 1995

Eur J Clin Pharmacol

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“…The "actual use" design has high assay sensitivity for detecting differences in rate of absorption between acetaminophen tablet formulations. Vegetarians were excluded from this study as there is evidence that the absorption of acetaminophen is impaired in this group of the population 19 . Female subjects were similarly excluded; it has been observed that the menstrual cycle has been associated with changes in gastric emptying patterns 20 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of a novel fast-dissolving acetaminophen tablet formulation (FD-APAP) and standard acetaminophen tablets using gamma scintigraphy and pharmacokinetic studies

Wilson¹,

Clarke²,

Starkey³

et al. 2011

Drug Development and Industrial Pharmacy

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“…N-Acetylcysteine (NAC) is a thiol-containing compound that has been used for over 30 years as the antidote for APAP toxicity in man [14]. NAC acts as a glutathione (GSH) precursor, promoting GSH synthesis and increasing hepatic GSH stores in order to detoxify N -acetyl- p -benzoquinone imine (NAPQI), the reactive intermediate metabolite of APAP [15,16].…”

Section: Introductionmentioning

confidence: 99%

Indocyanine green clearance varies as a function of N-acetylcysteine treatment in a murine model of acetaminophen toxicity

Milesi-Hallé

Abdel‐Rahman

Brown

et al. 2011

Chemico-Biological Interactions

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Standard assays to assess acetaminophen (APAP) toxicity in animal models include determination of ALT (alanine aminotransferase) levels and examination of histopathology of liver sections. However, these assays do not reflect the functional capacity of the injured liver. To examine a functional marker of liver injury, the pharmacokinetics of indocyanine green (ICG) were examined in mice treated with APAP, saline, or APAP followed by N-acetylcysteine (NAC) treatment. Male B6C3F1 mice were administered APAP (200 mg/kg IP) or saline. Two additional groups of mice received APAP followed by NAC at 1 or 4 h after APAP. At 24 h, mice were injected with ICG (10 mg/kg IV) and serial blood samples (0, 2, 10, 30, 50 and 75 min) were obtained for determination of serum ICG concentrations and ALT. Mouse livers were removed for measurement of APAP protein adducts and examination of histopathology. Toxicity (ALT values and histology) was significantly increased above saline treated mice in the APAP and APAP/NAC 4 h mice. Mice treated with APAP/NAC 1 h had complete protection from toxicity. APAP protein adducts were increased in all APAP treated groups and were highest in the APAP/NAC 1 h group. Pharmacokinetic analysis of ICG demonstrated that the total body clearance (Cl T ) of ICG was significantly decreased and the mean residence time (MRT) was significantly increased in the APAP mice compared to the saline mice. Mice treated with NAC at 1 h had Cl T and MRT values similar to those of saline treated mice. Conversely, mice that received NAC at 4 h had a similar ICG pharmacokinetic profile to that of the APAP only mice. Prompt treatment with NAC prevented loss of functional activity while late treatment with NAC offered no improvement in © 2010 Elsevier Ireland Ltd. All rights reserved.Address correspondence to: Laura P. James, MD, Section of Clinical Pharmacology and Toxicology, Department of Pediatrics, 3 Children's Way, Slot 512-23, Arkansas Children's Hospital, Little Rock, AR 72202, Phone: 501-364-1418, Fax: 501-364-3654, jameslaurap@uams.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflict of Interest StatementNone. ICG clearance at 24 h. ICG clearance in mice with APAP toxicity can be utilized in future studies testing the effects of novel treatments for APAP toxicity. NIH Public Access

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Impaired absorption of paracetamol in vegetarians.

Cited by 16 publications

References 20 publications

Paracetamol disposition in Thai patients during and after treatment of falciparum malaria

Paracetamol disposition in Thai patients during and after treatment of falciparum malaria

Comparison of a novel fast-dissolving acetaminophen tablet formulation (FD-APAP) and standard acetaminophen tablets using gamma scintigraphy and pharmacokinetic studies

Indocyanine green clearance varies as a function of N-acetylcysteine treatment in a murine model of acetaminophen toxicity

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