Acetaminophen toxicity and its prevention
A recent analysis found that an FDA mandate limiting acetaminophen co-prescription with opiates did lead to impressive decreases in acetaminophen hepatotoxicity, though there was no significant difference in hepatotoxicity from acetaminophen by itself despite a black box warning and patient education (see opiates dec combo with acetamin dec liver failue JAMA2023 in dropbox, or doi:10.1001/jama.2023.1080) Details : -- two databases were accessed: -- National Inpatient Sample (NIS): the largest publicly available all-payer US inpatient database with discharge data on more than 7 million inpatient stays annually -- Acute Liver Failure Study Group (ALFSG): a prospective, 32 center cohort of adult patients with acute liver failure (ALF), defined by an INR >1.5, hepatic encephalopathy, no prior chronic liver disease, and disease duration < 26 weeks -- the FDA issued a mandate to l...