Severe Acetaminophen Toxicity in a Patient Receiving Isoniazid

Abstract

Brief Reports15 November 1990Severe Acetaminophen Toxicity in a Patient Receiving IsoniazidRosanne Murphy, MD, Richard Swartz, MD, Paul B. Watkins, MDRosanne Murphy, MD, Richard Swartz, MD, Paul B. Watkins, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-10-799 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA woman who was being treated with isoniazid developed life-threatening hepatic and renal toxicity after ingesting not more than 11.5 g of acetaminophen. We believe the toxicity may have resulted from a previously unrecognized interaction between isoniazid and acetaminophen and propose a molecular basis for this interaction.Case ReportA previously healthy 19-year-old woman ingested a handful of acetaminophen tablets in a suicide gesture after a domestic dispute that occurred at 22:30 hours. The patient awoke the following morning at 06:00 hours with sharp abdominal pain, nausea, and vomiting, and was taken to the nearest hospital emergency room. The bottle...References1. Rumack B, Peterson R, Koch G, and Amara I. Acetaminophen overdose: 662 cases with evaluation of oral acetylcysteine treatment. Arch Intern Med. 1981;141:381-5. CrossrefGoogle Scholar2. Mitchell J, Thorgeirsson S, Potter W, Jollow D, and Reiser H. Acetaminophen-induced hepatic injury: protective role of glutathione in man and rationale for therapy. Clin Pharmacol Ther. 1974; 16:676-84. CrossrefMedlineGoogle Scholar3. Mitchell M, Hanew T, Meredith C, and Schenker S. Effects of oral contraceptive steroids on acetaminophen metabolism and elimination. Clin Pharmacol Ther. 1983;34:48-53. CrossrefMedlineGoogle Scholar4. Seeff L, Cuccherini B, Zimmerman H, Adler E, and Benjamin S. Acetaminophen hepatotoxicity in alcoholics. Ann Intern Med. 1986; 104:399-404. LinkGoogle Scholar5. Lieber C. 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Res Commun Chem Pathol Pharmacol. 1990;69:115-8. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Rosanne Murphy, MD; Richard Swartz, MD; Paul B. Watkins, MDFrom the University of Michigan Medical Center, Ann Arbor, Michigan. For current author addresses, see end of text. 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Moulding, MD, Allen G. Redeker, MD, Gary C. Kanel, MDCorrection: Acetaminophen ToxicityPREDOMINANT ROLE OF ALCOHOL-INDUCIBLE P-450s IN OXIDATIVE DAMAGE 15 November 1990Volume 113, Issue 10Page: 799-800KeywordsAbdominal painEmergency departmentIsoniazidNauseaSuicideToxicityVomiting ePublished: 1 December 2008 Issue Published: 15 November 1990 PDF downloadLoading ...