Abstract：
:Paracetamol overdose prior to the introduction of acetylcysteine was associated with significant morbidity. Acetylcysteine is now the mainstay of treatment for paracetamol poisoning and has effectively reduced rates of hepatotoxicity and death. The current three-bag intravenous regimen with an initial high loading dose was empirically derived four decades ago and has not changed since. This regimen is associated with a high rate of adverse effects due mainly to the high initial peak acetylcysteine concentration. Furthermore, there are concerns that the acetylcysteine concentration is not adequate for 'massive' overdoses and that the dose and duration may need to be altered. Various novel regimens have been proposed, looking to address these issues. Many of these modified regimens aim to decrease the rate of adverse reactions by slowing the loading dose and thereby decrease the peak concentration. We used a published population pharmacokinetic model of acetylcysteine to simulate these modified regimens. We determined mean peak and 20 h acetylcysteine concentrations and area under the under the plasma concentration-time curve to compare these regimens. Those regimens that resulted in a lower peak acetylcysteine concentration have been shown in studies to have a lower rate of adverse events. However, these studies were too small to show whether they are as effective as the traditional regimen. Further research is still needed to determine the optimum dose and duration of acetylcysteine that results in the fewest side-effects and treatment failures. Indeed, a more patient-tailored approach might be required, whereby the dose and duration are altered depending on the paracetamol dose ingested or paracetamol concentrations.
journal_name
Br J Clin Pharmacoljournal_title
British journal of clinical pharmacologyauthors
Chiew AL,Isbister GK,Duffull SB,Buckley NAdoi
10.1111/bcp.12789subject
Has Abstractpub_date
2016-03-01 00:00:00pages
471-81issue
3eissn
0306-5251issn
1365-2125journal_volume
81pub_type
杂志文章,评审abstract：AIMS:There are insufficient direct comparative studies addressing the impact of the type of statin on their respective efficacy in heart failure (HF). The aim of the current study was to compare the effects of lipophilic (atorvastatin) vs hydrophilic (rosuvastatin) on left ventricular function, inflammatory and fibrosi...
journal_title：British journal of clinical pharmacology
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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journal_title：British journal of clinical pharmacology
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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abstract：AIMS:Mycophenolic acid (MPA) suppresses lymphocyte proliferation through inosine monophosphate dehydrogenase (IMPDH) inhibition. Two formulations have been approved: mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS). Pantoprazole (PAN) inhibits gastric acid secretion, which may alter MPA expo...
journal_title：British journal of clinical pharmacology
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pub_type： 杂志文章
doi：10.1111/bcp.13725
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章,随机对照试验
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章
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更新日期：2007-05-01 00:00:00
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pub_type： 杂志文章,随机对照试验
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1982-11-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
doi：10.1111/j.1365-2125.2006.02742.x
更新日期：2006-12-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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pub_type： 杂志文章,评审
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1984-03-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
doi：10.1111/j.1365-2125.1991.tb05547.x
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2020-10-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章
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更新日期：1984-05-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章,评审
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更新日期：2015-05-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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更新日期：2005-11-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1991-12-01 00:00:00
abstract：:1. Hydrochlorothiazide (HCT, 50-75 mg) was administered orally to seven patients with cardiac failure. 2. Plasma levels and urinary concentration of HCT were determined by GLC. 3. The gastrointestinal uptake of the diuretic in three patients was reduced to approximately half that seen in healthy controls. 4. Plasma ha...
journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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更新日期：1979-06-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1992-02-01 00:00:00
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更新日期：2020-08-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
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更新日期：2007-01-01 00:00:00
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journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
doi：10.1111/j.1365-2125.1986.tb02888.x
更新日期：1986-09-01 00:00:00
abstract：:Mirabegron is used for the treatment of symptoms associated with overactive bladder syndrome. It selectively stimulates the β3 -adrenoreceptor, which relaxes the detrusor muscle. This improves urine storage by distension of the bladder body. ...
journal_title：British journal of clinical pharmacology
pub_type： 杂志文章
doi：10.1111/bcp.12647
更新日期：2015-10-01 00:00:00
