• Acetaminophen is a synthetic nonopiate derivative of p-aminophenol widely used in people for its antipyretic and analgesic properties.
• It is rapidly absorbed from the Gl tract.
• The metabolism of acetaminophen involves two major conjugation pathways in most species. Both involve cytochrome P450 metabolism, followed by glucuronidation or sulfation.
• Cats are more sensitive to acetaminophen toxicosis, because they are deficient in glucuronyl transferase and therefore have limited capacity to glucuronidate this drug.
• In cats, acetaminophen is primarily metabolized via sulfation; when this pathway is saturated, toxic metabolites are produced.
🔷 clinical signs
• Methemoglobinemia (mucous membranes brown or muddy in coltherapy Hepatotoxicity (icterus, vomiting, facial or paw edema, cyanosis, hepatic necrosis).
• Hypothermia, tachycardia, hyperpnea, dyspnea, weakness, lethargy, depression, hyperventilation and death.
🔷Treatment
•Acitvated Charcoal
0.5-1g/kg PO once with a cathartic(sorbitol)
• N-acetylcysteine
140mg/kg PO initially, then 70mg/kg PO q6-8 hrs for 36-72hrs
• Ascorbic acid
30mg/kg PO or injectable, BID
Reduce Methemoglobin levels to HB
Supportive therapy
-IV fluid and blood transfusion
Vitamin k in acute hepatic necrosis
Activated charcoal is commonly used to treat poisoning or drug overdoses, as it binds to toxins in the gastrointestinal tract, preventing their absorption into the bloodstream.
The standard dosing for activated charcoal in adults and children is typically:
Dose: 0.5 to 1 gram of activated charcoal per kilogram of body weight, taken by mouth (PO).
Administration: Activated charcoal is often given with a cathartic (e.g., sorbitol), which helps to accelerate the elimination of the charcoal-toxin complex from the gastrointestinal system. The cathartic helps induce a bowel movement, further decreasing the absorption of the toxin.
This dose and combination are typically administered once. It’s essential to follow specific medical guidance, especially in cases of significant poisoning, as the need for further treatment or additional doses of activated charcoal may vary based on the type of toxin and the clinical situation.
