Acetaminophen 引發之腎衰竭 - tsn.org.tw

1 Acetaminophen .. Acetaminophen . (1) glucuronide (2) sulfate (3). Acetaminophen (paracentamol) . (microsomal oxidation) glu- Acetaminophen . tathione ( 1) .. Acetaminophen .. glucuronide conjugation .. sulfate conjugation . 5% . Acetaminophen . (microsomal cytochrome) P-450 . Acetaminophen glutathione mer- 30 60 capturic acid [1] . 1. Acetaminophen . 92 15 1 17. Acetaminophen . glucuronide sulfate 4 6 Acetaminophen . microsomal . pathway . glutathione Acetaminophen methionine . N- acetylcysteine glutathione 1,000 IU/L . Acetaminophen . Acetaminophen PT . [1] . Acetaminophen (APAP) Acetaminophen . (deacetylation) deacetylated APAP (PAP) . 12 24 . P-450 NADPH oxygen . APBQI. electrophilic quinone . glutathione glutathione [1,4-5] . sulfhydryl group 2 7 . [2] . Acetaminophen [6] . methionine N- acetylcysteine . glutathione . aminophenol-S-conjugates . -glutamyl-trans- Acetaminophen . ferase activity [2-3] 1% 2% [5-6].

2 Acetaminophen . P - 4 5 0 renin aldosterone _ . rifampin sulfonylurea . glutathione . P-450 Eckardt Acetaminophen (4g) .. Acetaminophen 12 24. [7-9] . 18 92 15 1 . (creatinine kinase) .. Acetaminophen . (1) Acetaminophen aspirin . halothane methoxyflurane . granular cast (2) chloroform chromium copper sulfate (3) . 20 mmol/L (4) . 7 10 .. [10] .. Acetaminophen . (gastric aspiration) (larvage) . cast 30 . Acetaminophen Sulfhydr- yl ( N- acetylcysteine cysteamine or linear methionine) Acetaminophen . basolateral [11-12] . glutathione Acetaminophen .. N- acetylcysteine . Acetaminophen ( . Acetaminophen 200 g/ml 30 g/ml) . N- acetylcysteine 140 mg/kg . P-450 70 mg/kg 17 Acetaminophen . Acetaminophen N- acetylcysteine ace- Acetaminophen taminophen N- acetylcysteine N-ace- Acetaminophen tylcysteine .. Pres- [13] . cott's normogram . 200 g/ml 30 g/ml .. 150 g/ml 200 g/ml . 30 g/ml . 92 15 1 19. renal function.

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