van den Bersselaar, Luuk René and van den Brule, Judith Maria Dimphena and van der Hoeven, Johannes Gerardus (2020) Acetaminophen Use Concomitant with Long-Lasting Flucloxacillin Therapy: A Dangerous Combination. European Journal of Case Reports in Internal Medicine, 7 (7). pp. 1-3. ISSN ISSN: 2284-2594
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Abstract
Acetaminophen and flucloxacillin both interfere with the γ-glutamyl cycle. Long-lasting concomitant use of flucloxacillin and acetaminophen can lead to 5-oxoproline accumulation and severe high anion gap metabolic acidosis. Females and patients with sepsis, impaired kidney and/or liver function, malnutrition, advanced age, congenital 5-oxoprolinase deficiency and supratherapeutic acetaminophen and flucloxacillin dosage are associated with increased risk. Therefore, a critical attitude towards the prescription of acetaminophen concomitant with flucloxacillin in these patients is needed. We present the case of a 79-year-old woman with severe 5-oxoprolinaemia after long-lasting treatment with flucloxacillin and acetaminophen, explaining the toxicological mechanism and risk factors, and we make recommendations for acetaminophen use in patients with long-lasting flucloxacillin treatment.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 5-oxoproline, acetaminophen, flucloxacillin, anion gap, metabolic acidosis |
| Subjects: | 600 Tecnologia - Scienze applicate 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) |
| Depositing User: | Marina Spanti |
| Date Deposited: | 14 Dec 2021 14:36 |
| Last Modified: | 14 Dec 2021 14:36 |
| URI: | http://eprints.bice.rm.cnr.it/id/eprint/20932 |
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