CJEM Articles: acetaminophen

Displaying 1-3 of 3 results

  • Profound metabolic acidosis from pyroglutamic acidemia: an underappreciated cause of high anion gap metabolic acidosis
    September 2010 12 5
    David D. Sweet, Jan Jaap Bijlsma, Thomas J. Green

    The workup of the emergency patient with a raised anion gap metabolic acidosis includes assessment of the components of “MUDPILES” (methanol; uremia; diabetic ketoacidosis; paraldehyde; isoniazid, iron or inborn errors of metabolism; lactic acid; ethylene glycol; salicylates). This approach is usually sufficient for the majority of cases in the emergency department; however, there are many other etiologies not addressed in this mnemonic. Organic acids including 5-oxoproline (pyroglutamic acid) are rare but important causes of anion gap metabolic acidosis. We present the case of a patient with profound metabolic acidosis with raised anion gap, due to pyroglutamic acid in the setting of malnutrition and chronic ingestion of acetaminophen.

  • Myth: Ibuprofen is superior to acetaminophen for the treatment of benign headaches in children and adults
    May 2010 12 3
    Benoit Bailey, Evelyne Doyon-Trottier, Sergio Manzano
  • Emergency department visits for acetaminophen overdose: a Canadian population-based epidemiologic study (1997–2002)
    July 2007 9 4
    Abdel Aziz M. Shaheen, Bing Li, Robert P. Myers

    Objective: We describe the epidemiology of emergency department (ED) visits for acetaminophen overdose in a large Canadian health region, with a focus on sociodemographic risk factors and temporal trends.

    Methods: Patients presenting to an ED in the Calgary Health Region (population ~1.1 million) for acetaminophen overdose between 1997 and 2002 were identified using regional administrative data.

    Results: A total of 2699 patients made 3015 ED visits for acetaminophen overdose between 1997 and 2002, corresponding to an age- and sex-adjusted incidence of 45.7 per 100 000 population. Alcohol-related disorders were common (19%) and overdose rates were higher in females, younger patients, Aboriginals and social assistance recipients. The incidence decreased from 52.6 per 100 000 in 1997 to 35.1 per 100 000 in 2002 (34% relative reduction; p < 0.0005). When classified according to suicidal intent, the rates of intentional and unintentional overdose (69% and 25% of all overdoses, respectively) showed similar temporal trends. A marked seasonality was observed, with a peak in spring and early summer.

    Conclusions: ED visit rates for acetaminophen overdose fell between 1997 and 2002. High-risk groups, including young females and marginalized populations, may benefit from preventive and educational initiatives.