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Clinical Pediatrics, Vol. 40, No. 5, 243-248 (2001)
DOI: 10.1177/000992280104000501

Evaluation of Occult Acetaminophen Hepatotoxicity in Hospitalized Children Receiving Acetaminophen

Laura P. James, MD

Department of Pediatrics, Section of Pediatric Clinical Pharmacology and Toxicology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR

John T. Wilson, MD

Renee Simar, PhD

Department of Pediatrics, Section on Clinical Pharmacology, Louisiana State University School of Medicine, Shreveport, LA

Henry C. Farrar, MD

Department of Pediatrics, Section of Pediatric Clinical Pharmacology and Toxicology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR

Gregory L. Kearns, PharmD

Departments of Pediatrics and Pharmacology, University of Missouri-Kansas City, Section of Pediatric Clinical Pharmacology and Experimental Therapeutics, Mercy Children's Hospital, Kansas City, MO

Pippa M. Simpson, PhD

Department of Pediatrics, Center for Applied Research and Evaluation, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR

Jack A. Hinson, PhD

Neil R. Pumford, PhD

Departments of Pediatrics, Pharmacology and Toxicology, University of Arkansas for Medical Sciences, Little Rock, AR

Pediatric Pharmacology Research Unit Network

The safety of repeated doses of acetaminophen in ill children with the potential of reduced glutathione stores has been questioned. This study measured hepatic transaminases in children and adolescents (n=100) who received >6 therapeutic doses of acetaminophen over a 48-hour period of hospitalization. Acetaminophen-protein adducts were measured in a cohort of subjects with hepatic transaminase elevation (n=8) and in those (n=10) receiving concurrent drug therapy with agents that induce the cytochrome P450 enzymes involved in acetaminophen metabolism. Acetaminophen-protein adducts were not detected in this cohort of 18 subjects. Based on this pilot study, the routine use of acetaminophen at therapeutic doses in ill, hospitalized children and adolescents appears safe.


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