Intravenous Acetaminophen Overdose in an Infant With Toxicokinetic Data

Abstract

The toxicokinetics of pediatric intravenous (IV) acetaminophen (APAP) in overdose is not well described and few case reports with serial APAP concentrations allowing for calculations of half-life exist. Here, we report toxicokinetic data from a case of an unintentional IV APAP overdose in a 12-month-old male who was treated with NAC. Case Report: A 12-month-old (former 24 week gestational age), 8.7 kg male was hospitalized after an uneventful colostomy reversal. In the postoperative unit, the patient unintentionally received 1000 mg IV (114.9 mg/kg) acetaminophen instead of the intended 100 mg IV. Serial acetaminophen concentrations were drawn. The patient received IV Nacetylcysteine and ultimately had no adverse outcomes. Discussion: This case report adds to the existing literature regarding toxicokinetics of IV APAP in infants. Our patient had a calculated ke of 0.263 h-1, correlating with a half-life of 2.63 hours. Based on current available data, the half-life of IV APAP in infants varies (2.6 to 4.9 hours). The reason for this variation is unknown and further research is needed in this area.