PubMed · 9767979
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D Leuzinger. 1998-03-14. [The elderly in need].. https://pubmed.ncbi.nlm.nih.gov/9767979/
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Overdose of the popular, and relatively safe, analgesic acetaminophen (N-acetyl-p-aminophenol, APAP, paracetamol) can produce a fatal centrilobular liver injury. APAP-induced cell death was investigated in a differentiated, transforming growth factor alpha (TGFalpha)-overexpressing, hepatocyte cell line and found to occur at concentrations, and over time frames, relevant to clinical overdose situations. Coordinated multiorganellar collapse was evident during APAP-induced cytotoxicity with widespread, yet selective, protein degradation events in vitro. Cellular proteasomal activity was inhibited with APAP treatment but not with the comparatively nonhepatotoxic APAP regioisomer, N-acetyl-m-aminophenol (AMAP). Low concentrations of the proteasome-directed inhibitor MG132 (N-carbobenzoxyl-Leu-Leu-Leucinal) increased chromatin condensation and cellular stress responses preferentially in AMAP-treated cultures, suggesting a contribution of the proteasome in APAP- but not AMAP-mediated cell death. APAP-specific alterations to mitochondria were observed morphologically with evidence of mitochondrial proliferation in vitro. Biochemical alterations to cellular proteolytic events were also found in vivo, including APAP- or AMAP-mediated inhibition of caspase-3 processing. These results indicate that, although retaining some attributes of apoptosis, both APAP- and AMAP-mediated cell death have additional distinctive features consistent with longer term necrosis.
The use of blood spot collection cards is a simple way to obtain specimens for analysis of drugs with a narrow therapeutic window. We describe the development and validation of a microanalytical technique for the determination of paracetamol and its glucuronide and sulphate metabolites from blood spots. The method is based on reversed phase high-performance liquid chromatography with ultraviolet detection. The limit of detection of the method is 600 pg on column for paracetamol. Intra- and inter-day precision of the determination of paracetamol was 7.1 and 3.2% respectively. The small volume of blood required (20 microl), combined with the simplicity of the analytical technique makes this a useful procedure for monitoring paracetamol concentrations. The method was applied to the analysis of blood spots taken from neonates being treated with paracetamol.
A method based on capillary electrophoresis with electrochemical detection (CE-ED) was developed for the simultaneous determination of p-aminophenol and acetaminophen in the hydrolysates of acetaminophen. Effects of several important factors such as the acidity and concentration of running buffer, separation voltage, injection time, and working potential were investigated to acquire the optimum conditions. The detection electrode was a 300 microm carbon disc electrode at a working potential of +0.80 V (versus SCE). The two analytes can be well separated within 6 min in a 50 cm length fused silica capillary at a separation voltage of 18 kV in a 25 mM phosphate buffer (pH 6.5). The rate constants of acetaminophen hydrolysis in 0.5 M HCl at different temperatures were determined by monitoring the concentration changes of acetaminophen. At 70, 80, 90 and 100 degrees C, the measured rate constants of acetaminophen hydrolysis were 5.027 x 10(-3), 8.522 x 10(-3), 18.60 x 10(-3) and 32.76 x 10(-3) min(-1), respectively. The activation energy for acetaminophen hydrolysis was calculated to be 68.13 kJ mol(-1), which is in good agreement with the value in the literature.