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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Saturday, March 27, 2021

Fomepizol for APAP

CRITICALCARENOW
CriticalCareNow- By Ruben Santiago - March 25, 2021
The Debrief:
  • Acetaminophen overdose is a common presentation to the emergency department
  • NAC is the only FDA approved agent for APAP overdose and works primarily by providing GSH stores to detoxify NAPQI
  • There are instances when, despite therapy with NAC, hepatotoxicity still occurs
  • Fomepizole inhibits NAPQI through CYP2E1 inhibition and prevents further hepatotoxicity through JNK inhibition
  • For massive APAP overdoses, fomepizole may be considered as an adjunct to NAC to combat hepatotoxicity 
  • Always consult your poison control center at 1-800-222-1222 when these patients present”