四分之一磅的扑热息痛和丙二醇:一份病例报告。

Clinical Nephrology. Case Studies Pub Date : 2020-09-01 eCollection Date: 2020-01-01 DOI:10.5414/CNCS109936
Daniel Murphy, Abrar Khan, Christine Borscheid, Samy Riad
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引用次数: 2

摘要

特别是大量的对乙酰氨基酚过量,被称为大量,给标准化的,基于n -乙酰半胱氨酸的治疗带来了治疗挑战。除n -乙酰半胱氨酸外,另一个考虑因素是由于对乙酰氨基酚的可透析性,尽管同时去除解毒剂n -乙酰半胱氨酸阻碍了血液透析的开始。这种对乙酰氨基酚大量过量,同时可能摄入其他药物或非活性成分的病例,由于难以解释临床症状和实验室结果,可能会变得复杂。我们描述了一个病例,46岁的男子,我们咨询考虑透析治疗7小时后摄入125克对乙酰氨基酚。患者出现多种早期体征和实验室结果,与严重的对乙酰氨基酚过量相符。他还出现了一种罕见的症状,可能是对乙酰氨基酚干扰引起的实验室异常。最后,他可能因为一种“非活性”成分而中毒。患者接受单次延长血液透析(9.5小时)和增加n -乙酰半胱氨酸剂量治疗,结果呈阳性。在此,我们讨论决策和临床数据的解释有关透析治疗和其他治疗后大量对乙酰氨基酚过量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A quarter pound of acetaminophen with propylene glycol on the side: A case report.

Particularly large acetaminophen overdoses, termed massive, create a therapeutic challenge given the standardized, N-acetylcysteine-based treatment. One consideration in addition to N-acetylcysteine is the initiation of hemodialysis due to the dialyzable nature of acetaminophen, though encumbered by the concurrent removal of the antidote, N-acetylcysteine. Such cases of large acetaminophen overdose, along with possible concomitant ingestions of other drugs or inactive ingredients, can be complicated by challenging-to-interpret clinical signs and laboratory findings. We describe a case of a 46-year-old man for whom we were consulted regarding consideration of dialysis treatment 7 hours after ingestion of 125 g of acetaminophen. The patient developed multiple early signs and laboratory findings consistent with a significant acetaminophen overdose. He also developed a rarely described, likely acetaminophen-interference-induced laboratory abnormality. Finally, he possibly had toxicity from an "inactive" ingredient. He was treated with a single session of prolonged hemodialysis (9.5 hours) and increased dosing of N-acetylcysteine with a positive outcome. Herein, we discuss the decision making and interpretation of clinical data pertaining to dialysis treatment and other therapies after a massive acetaminophen overdose.

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