drpkaur
Forum Guru
Topics: 196
Posts: 810
|
A 25 year old female came to emergency foloowing a acetaminophen overdose,the acetaminophen level comes back as elevated but physician is unsure which management line to use.Which of the following features in medical history would classify the a ptient is at high risk?
1-hypothyroidism
2-anorexia nervosa
3-previous acetaminophen overdose
4-combined overdose with codeine
5-long term use valporate
|
| khorshid
Forum Guru
Topics: 32
Posts: 591
|
5.long term use of valproate
|
| dericanthony
Forum Newbie
Topics: 2
Posts: 28
|
khorshid are u sure about that becasue valporate ---antiepilepic induces the P450 system --- increase metabolism --- reduce risk
i am not sure of the answer maybe 1 2 or 3
hypothyroidism reduces metabolism --- increased risk
|
| misgana
Forum Newbie
Topics: 1
Posts: 3
|
:eyebrow
hypothyroidism and adrenal insufficency are said to be associated with
exaggerated response in opioid usage.
I 'll go with A.
|
| khorshid
Forum Guru
Topics: 32
Posts: 591
|
I am not sure if that's the best choice, but Valproic acid and its derivatives(valproate) inhibit p450.Actually valproic acid is the only anticonvulsant that inhibits p450 ,the rest are inducers! That's my reasoning, decreased metabolism which leads to increased toxicity. (that I had seen in a test before and right now just to make sure my memory is not playing with me I googled it  )
|
| drpkaur
Forum Guru
Topics: 196
Posts: 810
|
ANOREXIA NERVOSA...correct answer
Following factors have increased risk factor of heaptotoxicity in acetaminophen overdose.
alcoholics,
apatient on p450 inducer enzyme drug(rifampcin,phenytoin,carabamazepine)
anorexia nervosa
HIV
|
|
| |
| | | | | | |
