title: New problems arising from old drugs: second-generation effects of acetaminophen.
abstract: Acetaminophen (APAP)/paracetamol is one of the most commonly used over-the-counter drugs taken worldwide for treatment of pain and fever. Although considered as safe when taken in recommended doses not higher than 4 g/day, APAP overdose is currently the most important cause of acute liver failure (ALF). ALF may require liver transplantation and can be fatal. The reasons for APAP-related ALF are mostly intentional (suicidal) or unintentional overdose. However, results from large scale epidemiological studies provide increasing evidence for second generation effects of APAP, even when taken in pharmacological doses. Most strikingly, APAP medication during pregnancy has been associated with health problems including neurodevelopmental and behavioral disorders such as attention deficit hyperactivity disorder and increase in the risk of wheezing and incidence of asthma among offspring. This article reviews the epidemiological findings and aims to shed light into the molecular and cellular mechanisms responsible for APAP-mediated prenatal risk for asthma.
authors: Institute of Experimental Immunology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Gisa
authors: G
authors: Tiegs
authors: Khalil
authors: K
authors: Karimi
authors: Kay
authors: K
authors: Brune
authors: Petra
authors: P
authors: Arck
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects; D000818:Animals; D001249:Asthma / Q000139:chemically induced* / Q000453:epidemiology; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D002648:Child; D062787:Drug Overdose; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced; D018811:Maternal Exposure / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
keywords: asthma; childhood asthma; fetal development; immune adaptation to pregnancy; paracetamol; pregnancy; prenatal acetaminophen exposure