Disposition of acetaminophen in children with protein calorie malnutrition.

Acetaminophen disposition was studied in 11 children suffering from Protein Calorie Malnutrition (PCM) and 5 (age matched) control subjects using the time plasma concentration curve obtained after a single oral administration of 10 mg/kg of the drug. Absorption rate constant (Ka) was not altered in PCM. Elimination rate constant (Ke) was decreased significantly. PCM children had Ke 0.108 +/- 0.015 h-1 in comparison to the control value of 0.170 +/- 0.022 h-1. Plasma half-life (t1/2) was increased in PCM (8.14 +/- 1.30 h) in comparison of the control (4.33 +/- 0.52 h). Area under the curve (AUC) was also significantly increased in PCM (88.88 +/- 21.36 ug h/ml/kg) compared to the control (25.05 +/- 2.99 ug h/ml/kg). Time of drug disappearance was 44.7 +/- 7.1 hours in PCM compared to 24.6 +/- 3.3 hours in the control. Five PCM subjects could be restudied after rehabilitation and they demonstrated the return of elimination parameters towards control values. Drug therapy needs revision in light of these findings.