https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50481  1,000 U/L). The Australian Toxicology Monitoring (ATOM) study is a prospective observational study, recruiting via two poison information centers and four toxicology units. Patients following an acute APAP ingestion presenting < 24 hours post-ingestion were recruited. Initial samples were analyzed for APAP metabolites, those measured were the nontoxic glucuronide (APAP-Glu) and sulfate (APAP-Sul) conjugates and NAPQI (toxic metabolite) conjugates APAP-cysteine (APAP-Cys) and APAP-mercapturate (APAP-Mer). The primary outcome was hepatotoxicity. In this study, 200 patients were included, with a median ingested dose of 20 g, 191 received acetylcysteine at median time of 5.8 hours post-ingestion. Twenty-six patients developed hepatotoxicity, one had hepatotoxicity on arrival (excluded from analysis). Those who developed hepatotoxicity had significantly higher total CYP metabolite concentrations: (36.8 μmol/L interquartile range (IQR): 27.8-51.7 vs. 10.8 μmol/L IQR: 6.9-19.5) and these were a greater proportion of total metabolites (5.4%, IQR: 3.8-7.7) vs. 1.7%, IQR: 1.3-2.6, P < 0.001)]. Furthermore, those who developed hepatotoxicity had lower APAP-Sul concentrations (49.1 μmol/L, IQR: 24.7-72.2 vs. 78.7 μmol/L, IQR: 53.6-116.4) and lower percentage of APAP-Sul (6.3%, IQR: 4.6-10.9 vs. 13.1%, IQR, 9.1-20.8, P < 0.001)]. This study found that those who developed hepatotoxicity had higher APAP metabolites derived from CYP pathway and lower sulfation metabolite on presentation. APAP metabolites may be utilized in the future to identify patients who could benefit from increased acetylcysteine or newer adjunct or research therapies.]]> Wed 26 Jul 2023 18:22:28 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:36481 Wed 20 May 2020 16:22:43 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:51087 Wed 06 Mar 2024 15:25:20 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:54375 Tue 20 Feb 2024 20:24:25 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:55440 Thu 30 May 2024 15:41:44 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:12336 Sat 24 Mar 2018 08:15:52 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:17945 Sat 24 Mar 2018 07:56:29 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44755 Mon 24 Oct 2022 08:42:50 AEDT ]]>