Acetaminophen misconceptions


  • Barry H. Rumack M.D.

    Corresponding author
    1. University of Colorado School of Medicine, Greenwood Village, CO
    • Rocky Mountain Poison and Drug Center, Clinical Professor of Pediatrics, University of Colorado School of Medicine, 33 Silver Fox Circle, Greenwood Village, CO 80121
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Examination of the pharmacokinetics of acetaminophen can decrease misconceptions involved in clinical evaluation. Enzyme patterns and acetaminophen levels must be related to time and known metabolic phenomena. A careful look at ethanol and nutrition, especially fasting demonstrates that therapeutic doses of acetaminophen do not place patients at a greater risk in either of these instances. An overdose of acetaminophen in a chronic alcohol abuser may result in more severe hepatotoxicity than in the nonalcoholic. CYP2E1 and glutathione must be evaluated simultaneously rather than in isolation. Glucuronidation capacity in humans is not a factor except in massively overdosed patients. (HEPATOLOGY 2004;40:10–15.)