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Acetaminophen (Paracetamol)

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Critical Care Toxicology

Overview

Acetaminophen (paracetamol) was first discovered in Germany in 1887. It was initially rejected in favor of the structurally related phenacetin, as it was considered too toxic. It was only when restudied in the late 1940s that it was recognized as safer than alternative agents [1]. It was first marketed as an antipyretic and analgesic in the USA, as Tylenol, and UK, as Panadol, in the 1950s [2].

Toxicity from acetaminophen overdose was initially recognized in 1966, about 10 years after marketing, when the first cases were reported in Scotland [3, 4]. At that time there were no effective therapies, and morbidity and mortality from acetaminophen overdose climbed steadily as overdoses increased (Fig. 1) [5]. In the 1970s there were a significant number of cases in the Royal Infirmary poisons unit in Edinburgh, and Laurie Prescott and colleagues did important work, allowing rapid progress in knowledge. Initial studies showed the relationship of plasma concentration of...

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Authors and Affiliations

  1. Pharmacology, Toxicology and Therapeutics, The University of Edinburgh-College of Medicine and Veterinary Science, Edinburgh, UK

    D. Nicholas Bateman

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  1. D. Nicholas Bateman
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Correspondence to D. Nicholas Bateman .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Bateman, D.N. (2016). Acetaminophen (Paracetamol). In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_108-2

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  1. Latest

    Acetaminophen (Paracetamol)
    Published:
    28 September 2016

    DOI: https://doi.org/10.1007/978-3-319-20790-2_108-2

  2. Original

    Acetaminophen (Paracetamol)
    Published:
    03 October 2015

    DOI: https://doi.org/10.1007/978-3-319-20790-2_108-1

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