Use of the Rumack-Matthew Nomogram in Cases of Extended-Release Acetaminophen Toxicity
Authors: Susi Vassallo
Journal: Annals of Internal Medicine (1996)

Letters1 December 1996Use of the Rumack-Matthew Nomogram in Cases of Extended-Release Acetaminophen ToxicitySusi Vassallo, MD, Abu N.G.A. Khan, MD, and Mary Ann Howland, PharmDSusi Vassallo, MDNew York Regional Poison Control Center, New York, NY 10016., Abu N.G.A. Khan, MDNew York Regional Poison Control Center, New York, NY 10016., and Mary Ann Howland, PharmDNew York Regional Poison Control Center, New York, NY 10016.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-11-199612010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 17-year-old healthy girl presented to the hospital after a suicidal ingestion of 13 g of Extended-Relief Tylenol (McNeil Consumer Products Co., Fort Washington, Pennsylvania). She was asymptomatic, and vital signs and physical examination findings were normal. Acetaminophen levels were obtained 3 hours and 5 hours after ingestion. Both values were below the Rumack-Matthew nomogram (Figure 1). While the patient awaited psychiatric consultation, the acetaminophen level was measured for the third time 11 hours after ingestion. The level was 79.8 µg/mL and was in the toxic range when plotted on the nomogram. Oral N-acetylcysteine therapy was begun, ...References1. Cetaruk EW, Dart RC, Horowitz RS, Hurlbut KM. Extended-release acetaminophen overdose [Letter]. JAMA. 1996; 275:686. Google Scholar2. Graudins A, Aaron CK, Linden CH. Overdose of extended-release acetaminophen [Letter]. N Engl J Med. 1995; 333:196. Google Scholar3. Prescott LF, Wright N, Roscode P, Brown SS. Plasma-paracetamol half-life and hepatic necrosis in patients with paracetamol overdose. Lancet. 1971; 1:519-22. Google Scholar Author, Article, and Disclosure InformationAuthors: Susi Vassallo, MD; Abu N.G.A. Khan, MD; Mary Ann Howland, PharmDAffiliations: New York Regional Poison Control Center, New York, NY 10016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPopulation pharmacokinetic analysis of acetaminophen overdose with immediate release, extended release and modified release formulationsExtended Release Acetaminophen Overdose With Delayed Peak ConcentrationsThe standard treatment protocol for paracetamol poisoning may be inadequate following overdose with modified release formulation: a pharmacokinetic and clinical analysis of 53 casesUnexpected Late Rise in Plasma Acetaminophen Concentrations with Change in Risk Stratification in Acute Acetaminophen OverdosesDouble Peak and Prolonged Absorption After Large Acetaminophen Extended Release and Diphenhydramine IngestionDrug Metabolism and Pharmacokinetics in ToxicologyIndicadores de calidad para la asistencia urgente de pacientes con intoxicaciones agudas (Calitox-2006)Prolonged absorption and delayed peak paracetamol concentration following poisoning with extended‐release formulationThermodynamically based profiling of drug metabolism and drug–drug metabolic interactions: A case study of acetaminophen and ethanol toxic interactionAcetaminophen PoisoningAcetaminophen Poisoning: an Evidence-Based Consensus Guideline for Out-of-Hospital ManagementUpdates on Acetaminophen ToxicityA New Predictor of Toxicity Following Acetaminophen Overdose Based on Pretreatment ExposureThe Safety Profile of Sustained Release Paracetamol During Therapeutic Use and Following OverdosePreoperative use of herbal medicines: a patient survey 1 December 1996Volume 125, Issue 11Page: 940KeywordsArea under the curveDrugsGlutathioneIngestionLiver function testsPharmacokineticsToxicityToxicologyUrineVital signs ePublished: 15 August 2000 Issue Published: 1 December 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...