Hepatology Flashcards
1
Q
Tylenol in people with liver injury: Is it okay?
A
Fulminant hepatitis: Generally you should avoid it
Chronic hepatitis: Glutathione stores actually not depleted, neither is CYP2E1 activity increased, so okay to give relatively normal doses. Up to 4g/day seems safe for at least ~2 weeks from retrospective data, no prospective studies.
Chronic alcohol-associated liver inury: As above with glutathione, but here CYP2E1 pathway also upregulated. Therefore, more NAPQI will be produced given the same dose. Limit dose to 2g/day.
Acute alcohol ingestion: Paradoxically, competitive inhibition of CYP2E1 makes this even safer than taking acetominophen without alcohol ingestion. Totally safe, normal dose up to 4g/day.
