Insuficiencia hepática aguda por sobredosis accidental de paracetamol. Causas

Maria Asunción Urbón Puigbarraca

doi:10.30827/ars.v60i3.8775

Autores/as

Maria Asunción Urbón Puigbarraca Farmacéutica comunitaria

DOI:

https://doi.org/10.30827/ars.v60i3.8775

Palabras clave:

paracetamol, acetaminofeno, fallo hepático agudo, causas, sobredosis

Resumen

Objetivo: Determinar la prevalencia de sobredosis accidental con paracetamol que ocasionaron insuficiencia hepática aguda en el paciente y las causas de las sobredosis.

Método: Búsqueda bibliográfica de estudios de investigación originales, publicados desde enero del año 2010 hasta noviembre del 2018.

Resultados: Los pacientes ADULTOS que desarrollaron insuficiencia hepática aguda por sobredosis accidental con paracetamol, la gran mayoría eran polimedicados con opiáceos, pacientes que buscaban calmar el dolor, con una deficiente supervisión del tratamiento por parte de los médicos prescriptores y de los farmacéuticos, lo que dio lugar a la automedicación, la duplicidad, y como consecuencia “la sobredosis”.

En los NIÑOS, menores de 18 años, la principal causa fue ocasionada por errores de los cuidadores: confusión en la pauta de alternancia con ibuprofeno, por confundir la dosis y por pauta incorrecta a la edad y peso.

Conclusión: Existen casos de insuficiencia hepática aguda por sobredosis accidental con paracetamol, siendo las causas principales las ocasionadas por el sistema sanitario: deficiente gestión y supervisión del tratamiento por centros médicos y farmacias.

El grado de conocimiento de la medicación por el paciente es alarmante la percepción de “inocuo”, independiente de la dosis, entendida como la ausencia de toxicidad.

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Biografía del autor/a

Maria Asunción Urbón Puigbarraca, Farmacéutica comunitaria

Farmacáutica comunitaria.

Citas

Sabaté M, Ibáñez L, Pérez E, Vidal X, Buti M, Xiol X, et al. Paracetamol in therapeutic dosages and acute liver injury: causality assessment in a prospective case series. BMC Gastroenterol. 2011;11:80 2011;11:80 doi: 10.1186/1471-230X-11-80

Bunchorntavakul C, Reddy KR. Acetaminophen-related hepatotoxicity. Clin Liver Dis. 2013;17(4):587-607. doi: 10.1016/j.cld.2013.07.005

Gulmez SE, Larrey D, Pageaux GP, et al. Transplantation for Acute Liver Failure in Patients Exposed to NSAIDs or Paracetamol. Drug Saf. 2013; 36:135-144. doi: 10.1007/s40264-012-0013-7

Larsen F, Wendon J. Understanding paracetamol-induced liver failure. Intensive care medicine. Intensive Care Med 2014; 40:888–890. doi: 10.1186/1471-230X-11-80

Biolato M, et al. Liver transplantation for drug-induced acute liver failure. Eur Rev Med Pharmacol Sci. 2017; 21(1):37-45. PMID: 28379596

Hopkins RE, Dobbin M, Pilgrim JL. Unintentional mortality associated with paracetamol and codeine preparations, with and without doxylamine, in Australia. Forensic Sci Int. 2018; 282:122-126. doi: 10.1016/j.forsciint.2017.11.026

Pezzia C, Sanders C, Welch S, Bowling A, Lee WM. Acute Liver Failure Study Group. Psychosocial and behavioral factors in acetaminophen-related acute liver failure and liver injury. J Psychosom Res. 2017;101:51-57. doi: 10.1016/j.jpsychores.2017.08.006

Wróblewski T, Kobryń K, Kozieł S, Ołdakowska-Jedynak U, Pinkas J, Danielewicz R, et al. Acetaminophen (Paracetamol) induced acute liver failure - A social problem in an era of increasing tendency to self-treatment. Ann Agric Environ Med. 2015;22(4):762-767. doi: 10.5604/12321966.1185790.

Serper M, Wolf MS, Parikh NA, Tillman H, Lee WM, Ganger DR. Risk Factors, Clinical Presentation, and Outcomes in Overdose With Acetaminophen Alone or With Combination Products: Results From the Acute Liver Failure Study Group. J Clin Gastroenterol. 2016; 50(1):85-91. doi: 10.1097/MCG.0000000000000378.

Craig DG, Bates CM, Davidson JS, Martin KG, Hayes PC, Simpson KJ. Overdose pattern and outcome in paracetamol-induced acute severe hepatotoxicity. Br J Clin Pharmacol. 2011; 71(2):273-282. doi: 10.1111/j.1365-2125.2010.03819.x.

Rubin JB, Hameed B, Gottfried M, Lee WM, Sarkar M. Acetaminophen-induced Acute Liver Failure Is More Common and More Severe in Women. Clinical Gastroenterology and Hepatology. 2018; 16(6): 936-946. doi: 10.1016/j.cgh.2017.11.042

Tong HY, Medrano N, Borobia AM, Martínez AM, Martín J, Ruiz JA, et al. Hepatotoxicity induced by acute and chronic paracetamol overdose in adults. Where do we stand? Regul Toxicol Pharmacol. 2015; 72(2): 370-378. doi: 10.1016/j.yrtph.2015.05.011.

Pace JB, Nave V, Moulis M, Bourdelin M, Coursier S, Jean-Bart E, et al. Prescription of acetaminophen in five French hospitals: What are the practices? Thérapie. 2017; 72(5):579-586. [Artículo en francés] doi: 10.1016/j.therap.2017.01.007

Viguier F, Roessle C, Zerhouni L, Rouleau A, Benmelouka C, Chevallier A, et al. Clinical pharmacist influence at hospital to prevent overdosed prescription of acetaminophen]. Ann Pharm Fr. 2016; 74(6): 482-488. [Artículo en francés] DOI: 10.1016/j.pharma.2016.03.004

Charpiat B, Henry A, Leboucher G, Tod M, Allenet B. Overdosed prescription of paracetamol (acetaminophen) in a teaching hospital. Ann Pharm Fr. 2012; 70(4): 213-218. doi: 10.1016/j.pharma.2012.05.002.

Craig DG, Bates CM, Davison JS, Martin KG, Hayes PC, Simpson KJ. Staggered overdose pattern and delay to hospital presentation are associated with adverse outcomes following paracetamol-induced hepatotoxicity. Br J Clin Pharmacol. 2011; 73(2): 285–294. doi: 10.1111/j.1365-2125.2011.04067.x.

Khandelwal N, James LP, Sanders C, Larson AM, Lee WM. Acute Liver Failure Study Group. Unrecognized acetaminophen toxicity as a cause of indeterminate acute liver failure. Hepatology. 2011; 53(2):567-576. doi: 10.1002/hep.24060.

Frey SM, Wiegand TJ, Green JL, Heard KJ, Wilkins DG, Gorodetsky RM, et al. Confirming the Causative Role of Acetaminophen in Indeterminate Acute Liver Failure Using Acetaminophen-Cysteine Adducts. J Med Toxicol. 2015; 11(2): 218-222. doi: 10.1007/s13181-015-0476-x.

Boudjemai Y, Mbida P, Potinet-Pagliaroli V, Géffard F, Leboucher G, Brazier J, et al. Patients’ knowledge about paracetamol (acetaminophen): A study in a French hospital emergency department. Ann Pharm Fr. 2013; 71(4): 260-267. doi: 0.1016/j.pharma.2013.03.001.

Cipolat L, Loeb O, Latarche C, Pape E, Gillet P, Petitpain N. Acetaminophen: Knowledge, use and overdose risk in urban patients consulting their general practitioner. A prospective, descriptive and transversal study. Therapie. 2017; 72(4):453-463. [Artículo en francés] doi: 10.1016/j.therap.2016.12.012.

Severin AE, Petitpain N, Scala-Bertola J, Latarche C, Yelehe-Okouma M, Di-Patrizio P, et al. Good use and knowledge of paracetamol (acetaminophen) among self-medicated patients: Prospective study in community pharmacies. Thérapie. 2016; 71(3): 287-296. [Artículo en francés] doi: 10.1016/j.therap.2015.09.003.

Franko KR, Mekeel KL, Woelkers D, Khanna A, Hemming AW. Accidental acetaminophen overdose results in liver transplant during second trimester of pregnancy: a case report. Transplant Proc. 2013; 45(5):2063-2065. doi: 10.1016/j.transproceed.2012.10.046.

Thornton SL, Minns AB. Unintentional chronic acetaminophen poisoning during pregnancy resulting in liver transplantation. J Med Toxicol. 2012; 8(2): 176-178. doi: 10.1007/s13181-012-0218-2.

Claridge LC. Eksteen B, Smith A, Shah T, Holt AP. Acute liver failure after administration of paracetamol at the maximum recommended daily dose in adults. BMJ. 2010; 2:341. doi: 10.1136/bmj.c6764.

Tong HY, Medrano N, Borobia AM, Ruiz JA, Martínez AM, Martín J, Quintana M, et al. Hepatotoxicity induced by acute and chronic paracetamol overdose in children: Where do we stand? World J Pediatr. 2017;13(1):76-83. doi: 10.1007/s12519-016-0046-6.

Rajanayagam J, Bishop JR, Lewindon PJ, Evans HM. Paracetamol-associated acute liver failure in Australian and New Zealand children: high rate of medication errors. Arch Dis Child. 2015;100(1):77-80. doi: 10.1136/archdischild-2013-304902.

Leonis MA, Alonso EM, Im K, Belle SH, Squires RH. Chronic acetaminophen exposure in pediatric acute liver failure. Pediatrics. 2013;131(3): 740-746 doi: 10.1542/peds.2011-3035.

Brener P, Ballardo M, Mariani G, Ceriani JM. - Medication error in an extremely low birth weight infant: paracetamol overdose. - Arch Argent Pediatr. 2013; 111(1): 53-55. doi: 10.5546/aap.2013.53

Bucaretchi F, Fernandes CB, Branco MM, De-Capitani EM, Hyslop S, Caldas JP, et al. Acute liver failure in a term neonate after repeated paracetamol administration. Rev Paul Pediatr. 2014; 32(1):144-148. PMID: 24676202

Ogilvie JD, Rieder MJ, Lim R. Acetaminophen overdose in children. CMAJ. 2012;184(13):1492-1496. doi: 10.1503/cmaj.111338

Aabideen K, Moulton LS, Sills J. Accidental staggered paracetamol overdose: An interesting case report.J Pharmacol Pharmacother. 2011;2(3):189-190. doi: 10.4103/0976-500X.83286.

Alonso EM, James LP, Zhang S, Squires RH. Pediatric Acute Liver Failure Study Group. Acetaminophen Adducts Detected in Serum of Pediatric Patients With Acute Liver Failure. J Pediatr Gastroenterol Nutr. 2015; 61(1):102-107. doi: 10.1097/MPG.0000000000000814.

Figueroa FN, Forero J, León JA, Londoño AC, Echandía CA. Detección, manejo y percepción materna de la fiebre en niños Cali-Colombia. Rev.Fac.Med. 2012; 60(1): 40-49.

Serper M, Curtis LM, Bailey SC, McCarthy DM, Davis T, Jacobson K, et al. Effect of enhanced risk communication on patient comprehension of concomitant use warnings for acetaminophen-containing products: a randomized trial. Hepatology. 2013; 58(4 SUPPL. 1): 1192A

Michna E, Sheng M, Korves C, Dahl J; Removal of Opioid/Acetaminophen Combination Prescription Pain Medications: Assessing the Evidence for Hepatotoxicity and Consequences of Removal of These Medications. Pain Medicine. 2010; 11(3): 369–378. doi: 10.1111/j.1526-4637.2010.00811.x.