Beneficial effects of high-density lipoprotein administration on endotoxemia in an animal model of biliary cirrhosis

✍ Scribed by Tetsuji Fujita

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 56 KB
• Volume: 47
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.22174

✦ Synopsis

given 4 g of acetaminophen daily for 14 days experienced a significant rise in International Normalized Ratio (INR ϭ 3.45 for acetaminophen versus 2.66 for placebo at 14 days). 3 Because this complication does not technically fall under the category of liver injury or liver failure, AASLD will revisit its decision to include warfarin among the list of agents that can potentiate acetaminophen-induced liver injury. Instead, a separate warning criterion will be proposed to indicate that acetaminophen can increase the likelihood of an adverse event (bleeding) in patients taking warfarin.

(3) I stand by the statement that "most hepatologists might dispute" advertising touting acetaminophen as the safest over-thecounter analgesic. Each month the Acute Liver Failure Study Group identifies 4-6 patients with acetaminophen-related ALF, 30% of whom die. For each one of these cases, we typically discuss on our conference call two other "near misses," patients admitted with severe acetaminophen-induced liver injury and coagulopathy who do not become encephalopathic. Fortunately, most of these latter patients recover, but they still undergo a near-fatal experience and represent a huge burden to the health care system. That amounts to 150 or more cases of severe acetaminophen hepatotoxicity each year from our own practices-hard to ignore! In summary, Drs. Kuffner and Baggish raise questions around the edges of the problem, while missing the larger issue: "What can we do, together, to stop the large number of needless acetaminophen deaths that occur annually?"