What is the therapeutic dose for acetaminophen in adults and children in 24 hours?
80mg/kg for children and 4gram for adults.
100
In cellular bases , which cell organelle not functioning adequately and injured by acetaminophen over dose?
Mitochondria
100
How many stages for clinical course of acetaminophen poisoning?
four
100
What is the best antidote to reduce the risk of hepatoxcity and morality in patients?
N-acetylcysteine
100
What is the toxic level of ingestion for salicylate? Answer: greater than 150mg/kg
greater than 150mg/kg
200
What is the acetaminophen dosage when toxicity is most likely to happen?
single ingestion > 250mg/kg or >than 12 gram over in 24 hours period
200
What is the toxic metabolite of a acetaminophen which cause hepatic injury?
N-acetyl-p-benzoquinoneinine (NAPQI)
200
nausea, vomiting, diaphoresis, pallor, malaise and lethargy or patient can be asymptomatic
.In stage 1 (0.5-24) hrs what is the most often manifestations, patients are present with?
200
Plasma acetaminophen level above 300 mg/L at 4 hours after ingestion and above 50 mg/L at 15 hours predict 90% probability for the presence of which organ failure?
.
Severe or fatal liver damage
200
What is the mechanism of ASA toxicity?
Answer: uncoupling oxidative phosphorylation
300
What is the peak plasma concentration for acetaminophen overdose
between one and a half and two hours after an oral dose
300
Cell death caused by the toxics acetaminophen metabolites, what is the name of the phagocytic macrophages of the liver cells, which activates first?
Kupffer cells
300
In stage 2 (24-72) hours, what are the name of liver enzymes elevate within 24 hours of acetaminophen over dose?
Aminotransferete, ALT and AST.
300
what are the two signs of acute liver failure related to acetaminophen overdose with no presence of liver disease?
hepatic encephalopathy and coagulopathy
300
In overdose, what is the half life of salicylate?
>20 hours
400
When is hepatoxicity is apparent after acetaminophen over dose
After 24 to 48 hours
400
A therapeutic doses of Acetaminophen, NAPQI is inactivated by conjugation with?
hepatic glutathione
400
stage 3 after 72 to 96 hours.
Which stage liver function abnormalities peak post ingestion acetaminophen poisoning?
400
What intravenous is commonly administered in ASA OD to achieve urine alkalinization?
1 liter of D5W with 3 amps of sodium bicarbonate plus 40 meq potassium chloride (KCL)
500
When the prompt treatment should occur for acetaminophen overdose to prevent hepatic injury?
before 8 hours
500
What are signs and symptoms of severe hepatoxcity?
1- plasma ALT and AST levels > 10,000 ul.
2- prolongation of PT and INR
3- hypoglycaemia
4- lactic acidosis
5-total bilirubin concentration > 4.0 mg/dL
6-Acute renal failure, secondary to acute tubular necrosis.
500
What is the method of choice when unable to correct salicylate induced acid-base and electrolyte imbalance?