Acetaminophen; Acetamide, N-(4-hydroxyphenyl)-; Tylenol (trading); Paracetamol (Acephen); Allyl alcohol; Acetophenone. Acetal; 4 acetaminophen; Acetaminophen; 4 paracetamol; Acetaminophen; Acetaminophen; Acetaminophen; Acetaminophen; 4 acetaminophenol; Acetaminophenol; Eight party; Alviden; Amadir; The symplectic three o; Anafuron; The path amine; Application program; apotel; Joint hormone; Benzene nandrolone; Karl Bohr; cp 500; Dafalgan; Dartill; Gravels; Disperse; The dollar; Many plant; Many drugs; Dristan AF; Bisoprolol; efferalgan; Ivy Gump; Ernesto method; Full of energy; European Union Medical Sciences; Non-brick; Mr Deng; Fibrinol; Gelatin; Headache intensity allergy; Hexagon. 4-hydroxyacetanilide; 4' hydroxyacetanilide; Janupap; Mo to him; The spring; Wright card; The da mo; Metal; The gram force; N acetyl 4 aminophenol; N acetyl p-aminophenol; A nap; Nestle. Neoccitric acid; New Dalming; Mental derangement. Nobel's; Pacemakers. The palm trees. Mr Moore; Palmer so much; Soluble panadol; Palmer Nassau; Panedil; Acetaminophen; Paracetaminophenol; Acetaminophen; Paracetamol; Paracetamol ester; P-hydroxyacetanilide; Para Aaron; Maximum parameter; Support; Parameter table; Pasolind; Pasolind. Phenol; Polo Finn; Rapid; Puerno; The hot; Fast alcohol; Draw in Finland; Rodin. A seed; Zinn street; Tabarkin; Tachipilin; tachipirina; Tapa; Tempura. Aragorn; Tramir; Trupado; Tylenol. Tylenol nr 1; The laval pull many; Azole benzene; Acetamide, N-(4-hydroxyphenyl)-; 4-hydroxyacetanilide; cp500; N acetyl p-aminophenol; Acetaminophen.
Acetaminophen protein adducts have been widely used as a measure of metabolism in experimental models of acetaminophen toxicity. Early attempts to measure adducts in clinical samples used complex and cumbersome assays that were not suitable for analyzing large numbers of samples. Hinson and Poulsen reported the successful use of competitive enzyme linked immunosorbent assay (ELISA) to detect acetaminophen protein adducts in patients with significantly elevated ALT induced by acetaminophen overdose. Recent developments in accurate, sensitive and specific HPLC analyses using electrochemical detection (HPLC-EC) have contributed to further studies of adducts in patients with acetaminophen hepatotoxicity. The adduct was detected in patients with known ALF, whereas it was absent or negligible in those with other known ALF causes. In addition, adduct was detected in 19% of patients with unknown etiology of ALF, indicating the potential diagnostic value of this test. In patients with acetaminophen ALF, adducts were shown to be associated with AST and ALT (R = 0.86). Acceptor-operator curve analysis of patients with ALT 1,000 IU/L showed that serum sensitivity and specificity were 97% and 95%, respectively, with adduct value 1.1 nmol/mL. In subsequent studies, more ALF patients with unknown etiology were used (n=110), and 18% of the patient samples contained admixtures greater than 1.0 nmol/mL. In addition, 95% of samples from suspected ALF patients had adjuncts higher than this value. The elimination of T1/2 of ALF adult acetaminophen protein adjunct (mean elimination of T1/2 =41.3±8.3 h) exceeded that of the reported maternal compound acetaminophen (median elimination of T1/2 in patients with acetaminophen overdose was 5.4 h; Median T1/2 for patients with toxicity and encephalopathy, 18.4 hours). Therefore, these data suggest that determination of adduct levels in patients with unknown etiology of ALF would be a valuable addition to the diagnostic evaluation of these patients.
