title: Evaluation of bilirubin displacement effect by acetaminophen in vitro.
abstract: BACKGROUND
  The use of acetaminophen as a drug for pain control is expected to increase in the neonatal field. The displacement factor of acetaminophen in the reaction in the glucose oxidase peroxidase method is very high, but is also considered to be inaccurate based on physicochemical properties.
  
  
  METHODS
  Unbound bilirubin was measured using the erythrocyte-bound bilirubin measurement method and glucose oxidase peroxidase method by the addition of acetaminophen or sulfisoxazole. The displacement factor was measured using glucose oxidase peroxidase method with the addition of tert-butyl-p-hydroxyanisole.
  
  
  RESULTS
  Acetaminophen did not increase erythrocyte-bound bilirubin, and the addition of tert-butyl-p-hydroxyanisole lowered its displacement factor. On the other hand, sulfisoxazole increased erythrocyte-bound bilirubin, while tert-butyl-p-hydroxyanisole did not change its displacement factor.
  
  
  CONCLUSIONS
  Acetaminophen is an accelerator of the reaction in the glucose oxidase peroxidase method and does not displace bilirubin from human serum albumin.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sugino
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan hiokada@kms.ac.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kusaka
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Itoh
mesh_terms: D000082:Acetaminophen / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology; D058633:Antipyretics / Q000494:pharmacology; D001663:Bilirubin / Q000097:blood*; D001667:Binding, Competitive; D006801:Humans; D066298:In Vitro Techniques; D010544:Peroxidases / Q000378:metabolism*; D011485:Protein Binding; D012709:Serum Albumin / Q000378:metabolism*; D013444:Sulfisoxazole / Q000494:pharmacology*
chemical_list: D000890:Anti-Infective Agents; D058633:Antipyretics; D012709:Serum Albumin; D000082:Acetaminophen; D013444:Sulfisoxazole; D010544:Peroxidases; C023057:glucose peroxidase; D001663:Bilirubin
keywords: Erythrocyte-bound bilirubin; accelerator; glucose oxidase peroxidase method; sulfisoxazole; unbound bilirubin