Seifert C F, Lucas D S, Vondracek T G, Kastens D J, McCarty D L, Bui B
Section of Pharmacy Practice, College of Pharmacy, University of Oklahoma, Oklahoma City.
Pharmacotherapy. 1993 Jul-Aug;13(4):391-5.
Alcoholics may be predisposed to the hepatotoxicity of acetaminophen due to increased activity of the cytochrome P-450 system and decreased hepatic glutathione. To date, scattered case reports provide only a brief sketch of the frequency and pattern of acetaminophen use by alcoholics. To determine these variables, we obtained a detailed ethanol and drug history from patients answering yes to at least one of four questions on the CAGE questionnaire. Patients were classified in terms of their acetaminophen use as nonusers, users as necessary, or regular users. Regular users were further classified as nondaily or daily users, or abusers (> 4 g/day). A total of 64 patients were enrolled in the study. The average number of positive responses to the CAGE questionnaire was 3.27 +/- 0.91. Of the 64 patients, 34 (53.1%) were continuous daily drinkers, 28 (43.8%) binge drinkers, and 2 (3.1%) had completely discontinued using alcohol. By history, 32 (50)% were nonusers of acetaminophen. Of the 32 users, 12 (37.5%) stated they took it as needed and 20 (62.5%) took it regularly. Of the 20 regular users, 7 (35%) were nondaily users, 11 (55%) were daily users, and 2 (10%) were abusers. Approximately 31% of alcoholics used acetaminophen regularly, most on a daily basis, with 1 of every 10 abusing the drug. Of the 64 alcoholics interviewed, 3 (4.7%) fit the drinking and acetaminophen use patterns theoretically associated with hepatotoxicity.
由于细胞色素P - 450系统活性增加和肝内谷胱甘肽减少，酗酒者可能易患对乙酰氨基酚肝毒性。迄今为止，零散的病例报告仅简要概述了酗酒者使用对乙酰氨基酚的频率和模式。为确定这些变量，我们从对CAGE问卷中四个问题至少有一个回答为肯定的患者那里获取了详细的乙醇和药物使用史。根据对乙酰氨基酚的使用情况，将患者分为非使用者、必要使用者或经常使用者。经常使用者进一步分为非每日使用者、每日使用者或滥用者（>4克/天）。共有64名患者纳入该研究。对CAGE问卷的平均阳性回答数为3.27±0.91。64名患者中，34名（53.1%）为持续每日饮酒者，28名（43.8%）为暴饮者，2名（3.1%）已完全戒酒。根据病史，32名（50%）为对乙酰氨基酚非使用者。在32名使用者中，12名（37.5%）称按需服用，20名（62.5%）经常服用。在这20名经常使用者中，7名（35%）为非每日使用者，11名（55%）为每日使用者，2名（10%）为滥用者。约31%的酗酒者经常使用对乙酰氨基酚，多数为每日使用，每10人中就有1人滥用该药物。在接受访谈的64名酗酒者中，3名（4.7%）符合理论上与肝毒性相关的饮酒和对乙酰氨基酚使用模式。
