Effects of PEG-electrolyte (Colyte) lavage on serum acetaminophen concentrations. A model for treatment of acetaminophen overdose.
The purpose of this study was to evaluate whole gut lavage with polyethylene glycol electrolyte solution (Colyte), as a potentially adjunctive measure in lowering serum acetaminophen levels. The effect of bowel lavage was evaluated on serial serum acetaminophen concentrations after 2-g and 4-g doses in 7 and 12 male patients, respectively. Mean peak level of serum acetaminophen after 2 g (60 min after intake) was not significantly lowered by bowel lavage. After 4 g, peak acetaminophen serum levels were significantly lower after bowel lavage (65.4% of controls, P < 0.001). Urinary concentrations of the mercapturic acid conjugate of the toxic metabolite were also significantly reduced by lavage (55% after 2 g and 45% after 4 g, P < 0.01). Activated charcoal given orally after administration of 4 g of acetaminophen had no significant effect on peak serum levels and had no additive effect on lavage. These studies suggest that rapid, complete bowel lavage with a polyethylene glycol electrolyte solution may be beneficial as an adjunct to the treatment of the acetaminophen intoxication.
Hassig
S R
SR
Section of Gastroenterology, Veterans Administration Medical Center, Syracuse, New York 13210.
Linscheer
W G
WG
Murthy
U K
UK
Miller
C
C
Banerjee
A
A
Levine
L
L
Wagner
K
K
Oates
R P
RP
D000082:Acetaminophen / Q000493:pharmacokinetics* / Q000506:poisoning; D000111:Acetylcysteine / Q000652:urine; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002606:Charcoal / Q000494:pharmacology; D062787:Drug Overdose / Q000628:therapy; D004573:Electrolytes / Q000494:pharmacology*; D005751:Gastric Lavage; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D011092:Polyethylene Glycols / Q000494:pharmacology*
D001786:Blood Glucose; D004573:Electrolytes; C033608:Golytely; D002606:Charcoal; D000082:Acetaminophen; D011092:Polyethylene Glycols; D000111:Acetylcysteine