Titre du document / Document title

Cimetidine as adjunctive treatment for acetaminophen overdose

Auteur(s) / Author(s)

BURKHART K. K. ; JANCO N. ; KULIG K. W. ; RUMACK B. H. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Univ. Colorado health sci. cent., Denver gen. hosp., emergency medicine res. cent., Denver CO 80204, ETATS-UNIS

Résumé / Abstract

The aim of this study was to determine if cimetidine in addition to N-acetylcysteine and standard supportive care provide additional hepatoprotection following acute acetaminophen poisoning. It was designed as a prospective study with alternate month treatment protocol, and the work was carried out at a regional certified poison information centre. For a 2-year period, consultations received by the Rocky Mountain Poison Center involving acute acetaminophen overdose patients with a serum level above the nomogram line, but who would not receive N-acetylcystine therapy until at least 8 h postingestion, were prospectively evaluated for adjunctive treatment with cimetidine. All patients received standard supportive therapy and N-acetylcysteine treatment. During odd numbered months, cimetidine 300 mg was administered intravenously every 6 h for the duration of N-acetylcysteine therapy. Forty-one cimetidine treated patients were compared to 66 patients in the control group. The peak measured AST levels (+/- s.e.) were 1259+/-330 and 1301+/-451 for the control and cimetidine treatment groups, respectively (P=0.94). Fourteen of 64 patients (21%) in the control group and 8/41 patients (20%) in the cimetidine group developed an AST>1000 IUL^-1. There were no statistical differences between the cimetidine-treated and control groups when classified by AST<100 IUL^-1, 100-1000 IUL^-1, or >1000 IUL^-1. The addition of cimetidine therapy to standard N-acetylcysteine treatment did not provide additional hepatoprotection in acutely acetaminophen poisoned patients when treatment was started later than 8 h post overdose. Larger doses of cimetidine along with more frequent or continuous intravenous administration may warrant further study

Revue / Journal Title

Human & experimental toxicology   ISSN 0960-3271 

Source / Source

1995, vol. 14, n^o3, pp. 299-304 (34 ref.)

Langue / Language

Anglais

Editeur / Publisher

Arnold, London, ROYAUME-UNI  (1990) (Revue)

Mots-clés anglais / English Keywords

Analgesic ; Drug intoxication ; Human ; Treatment ; Chemotherapy ; Hepatic disease ; Adjuvant treatment ;

Mots-clés français / French Keywords

Paracétamol ; Analgésique ; Intoxication médicamenteuse ; Homme ; Traitement ; Chimiothérapie ; Foie pathologie ; Cimétidine ; Traitement adjuvant ;

Mots-clés espagnols / Spanish Keywords

Analgésico ; Intoxicación medicamentosa ; Hombre ; Tratamiento ; Quimioterapia ; Hígado patología ; Tratamiento adyuvante ;

Localisation / Location

INIST-CNRS, Cote INIST : 19290, 35400005589289.0100