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PubMed · 7914547

Delayed toxic acetaminophen level after initial four hour nontoxic level.

T V Tighe·F G Walter
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Abstract

Antidotal therapy for acetaminophen poisoning is routinely based on a single acetaminophen level obtained four or more hours after ingestion. Some experts recommend additional acetaminophen levels if there are coingestants. This case report describes a 20-year-old woman who ingested acetaminophen 13 g, propoxyphene napsylate 2 g and naproxen sodium 3.75 g. A 4.5 h acetaminophen level was 83.5 mg/L (nontoxic). A 6.75 h acetaminophen level was 124.6 mg/L (toxic). The patient was treated with N-acetylcysteine and recovered without sequelae. This is the first published report of a delayed toxic acetaminophen level occurring after an initial nontoxic level. Although rare, the possibility of a delayed peak acetaminophen level merits consideration, particularly with coingestions that delay gastric emptying.

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AcetaminophenAcetylcysteineAdultDextropropoxypheneDrug OverdoseFemaleHumansNaproxenTime FactorsCase ReportsJournal Article

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T V Tighe, F G Walter. 1994. Delayed toxic acetaminophen level after initial four hour nontoxic level.. https://doi.org/10.3109/15563659409011045

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