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Paediatric Laboratory Medicine

Acetaminophen

Clinical Significance

Acetaminophen is one of the most widely used analgesics on the market today. It is available in many formulations including liquid, tablets, capsules and suppositories. The chemical name is N-acetyl-p-aminophenol (APAP). Acetaminophen has an excellent safety profile in therapeutic doses, but hepatotoxicty can develop in overdose situations. Metabolism is primarily hepatic with the half life being 2 to 4 hours. The parent compound, acetaminophen is non-toxic, but the metabolite N-acetyl-benzoquinoneimine (NAPQI) is toxic. Normally, glutathione will bind the NAPQI and form a non-toxic conjugate which is excreted. In overdose situations, as glutatione stores are depleted, the NAPQI binds to the lipid bilayer of the hepatocytes resulting in necrosis. N-acetylcysteine (NAC) is an effective antidote.

Test Name

Acetaminophen

Alternate Name/ Synonym

Tylenol, Paracetamol

Test Code

FACEB

Drug Class

Analgesic

Division

Toxicology

Method

Abbott Architect ci4100

External Proficiency Testing

QMPLS, CAP

Turn Around Time

Daily, Stat

Specimen Type

Serum, Plasma (Heparin)

Minimum Specimen Requirements

150 uL

Optimal Collection Time

Peak, trough

Storage/Transportation

Refrigerator (4 - 8°C): 2 days,
Freezer (-20°C) long term

Approval is not required

CPT Codes

82003

Shipping and Contact Information

The Hospital for Sick Children
Rapid Response Laboratory
170 Elizabeth Street, Room 3642
Toronto, ON
M5G 2G3
Canada
Phone: 416-813-7200
Phone: 1-855-381-3212

Therapeutic Range

Not detected

Critical Values

Refer to Rumack-Matthew Nomogram