N-Acetyl cysteine and erdosteine treatment in acetaminophen-induced liver damage.
OBJECTIVE
This study is aimed to investigate the efficacy of erdosteine usage in acetaminophen-induced liver damage and to compare it with N-acetyl cysteine (NAC) in the treatment and prevention of liver toxicity due to overdose of acetaminophen.


METHODS
The rats were separated into the following six groups of seven rats each: control group; acetaminophen (1 g/kg, orally); acetaminophen (1 g/kg, orally) + erdosteine (150 mg/kg/day, orally); acetaminophen (1 g/kg, orally) + NAC (140 mg/kg loading dose, followed by 70 mg/kg, orally); NAC (140 mg/kg loading dose, followed by 70 mg/kg, orally); erdosteine (150 mg/kg/kg, orally), subsequently. In all the groups, potential liver injuries were evaluated using biochemical and hematological analyses, oxidant-antioxidant parameters and histopathological parameters.


RESULTS
In acetaminophen-treated group, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total oxidant status (TOS) in the blood, prothrombin time (PT) and international normalized ratio (INR) were significantly increased when compared with controls. However, total antioxidant capacity (TAC) and glutathione (GSH) levels were decreased in group treated with acetaminophen, when compared with control group. Levels of AST, ALT and TOS, PT and INR were decreased in groups treated with NAC and erdosteine after acetaminophen administration, but the levels of TAC and GSH were increased. Histopathological improvements were observed in the groups treated with NAC and erdosteine after acetaminophen administration.


CONCLUSIONS
The present study demonstrated that, in the prevention of liver damage induced by acetaminophen intoxication, an early treatment with a single dose of erdosteine was beneficial instead of NAC administration.
Department of Emergency Medicine, Duzce University School of Medicine, Duzce, Turkey.
Ayhan
A
Saritas
Department of Emergency Medicine, Duzce University School of Medicine, Duzce, Turkey hayatikandis@yahoo.com.
Hayati
H
Kandis
Department of Family Medicine, Duzce University School of Medicine, Duzce, Turkey.
Davut
D
Baltaci
Department of Pathology, Duzce University School of Medicine, Duzce, Turkey.
Umran
U
Yildirim
Department of Emergency Medicine, Harran University School of Medicine, Sanliurfa, Turkey.
Halil
H
Kaya
Department of Emergency Medicine, Mustafa Kemal University School of Medicine, Hatay, Turkey.
Ali
A
Karakus
Department of Anatomy, Duzce University School of Medicine, Duzce, Turkey.
Serdar
S
Colakoglu
Department of Biochemistry, Duzce University School of Medicine, Duzce, Turkey.
Ramazan
R
Memisogullari
Department of Family Medicine, Duzce University School of Medicine, Duzce, Turkey.
Ismail Hamdi
IH
Kara
D000082:Acetaminophen / Q000633:toxicity*; D000111:Acetylcysteine / Q000627:therapeutic use*; D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D000931:Antidotes / Q000627:therapeutic use*; D058633:Antipyretics / Q000633:toxicity*; D001219:Aspartate Aminotransferases / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D019934:International Normalized Ratio; D016877:Oxidants / Q000097:blood; D011517:Prothrombin Time; D051381:Rats; D017208:Rats, Wistar; D013864:Thioglycolates / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*
D000931:Antidotes; D058633:Antipyretics; D016877:Oxidants; D013864:Thioglycolates; D013876:Thiophenes; D000082:Acetaminophen; C048498:erdosteine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000111:Acetylcysteine