Egyptian perspectives on potential risk of paracetamol/acetaminophen-induced toxicities: Lessons learnt during COVID-19 pandemic

Mostafa, Enas M. A.; Tawfik, Ayat Mahmoud; Abdelrahman, Khadiga M.

doi:10.1016/j.toxrep.2022.03.035

Cited by 29 publications

(23 citation statements)

References 48 publications

(74 reference statements)

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“…APAP is the most commonly used antipyretic and analgesic drug in clinical settings, and its use was especially high during the COVID-19 pandemic as a first-line drug for COVID-19 patients. However, the excessive and unreasonable reuse of APAP can cause serious liver damage in patients, which has become a concerning phenomenon [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Confusoside from Anneslea fragrans Alleviates Acetaminophen-Induced Liver Injury in HepG2 via PI3K-CASP3 Signaling Pathway

Zhao

Zhang

et al. 2023

Molecules

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Confusoside (CF), a major chemical compound in the leaves of Anneslea fragrans Wall., is a dihydrochalcone glycoside with excellent antioxidant and anti-inflammatory effects. However, the hepatoprotective effect of CF has not been described. This study aimed to explore the hepatoprotective effect of CF against acetaminophen (APAP)-induced hepatic injury in HepG2 cells. First, the potential hepatoprotective effect mechanisms of CF were predicted by network pharmacology and were thought to involve reducing inflammation and inhibiting apoptosis. Target proteins (phosphatidylinositol3-kinase (PI3K) and caspase-3 (CASP3)) were found via molecular docking analysis. To verify the predicted results, an analysis of biological indicators was performed using commercial kits and Western blotting. The results showed that CF significantly decreased the levels of liver injury biomarkers (ALT, AST, and LDH), strongly inhibited the production of inflammatory cytokines (IL-1β, IL-6, and TNF-α) and the NO level via inhibiting the activation of the NF-κB signaling pathway, and markedly regulated the expression levels of Bcl2, Bax, and cleaved-CASP3/9 proteins by activating the PI3K-CASP3 apoptosis pathway. The results demonstrated that CF has a therapeutic effect on APAP-induced liver injury by inhibiting intracellular inflammation and cell apoptosis, indicating that CF may be used as a potential reagent for the prevention and treatment of APAP-induced liver injury.

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Section: Introductionmentioning

confidence: 99%

Confusoside from Anneslea fragrans Alleviates Acetaminophen-Induced Liver Injury in HepG2 via PI3K-CASP3 Signaling Pathway

Zhao

Zhang

et al. 2023

Molecules

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“…Acetaminophen, which is one of the most consumed analgesics around the world, had increased worldwide because of its analgesic properties (Mostafa et al 2022 ). Acetaminophen gave the highest concentrations ranging from 91.85 to 3377 ng L −1 (LL2G and LL2F respectively), with a mean value of 859.3 ng L −1 .…”

Section: Resultsmentioning

confidence: 99%

Presence and toxicity of drugs used to treat SARS-CoV-2 in Llobregat River, Catalonia, Spain

Dominguez-García

Rodríguez

Barata

et al. 2023

Environ Sci Pollut Res

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the on-going COVID-19 pandemic. In March 2020, it was declared global pandemic, causing millions of deaths. An evident tendency of global pharmaceutical consumption due to COVID-19 pandemic should be seen worldwide, and this increase might suppose an environmental threat. Pharmaceuticals administrated at home or in pharmacies are excreted by faeces and urine after consumption, and wastewater treatment plants (WWTPs) are not able to remove all pharmaceuticals residues that eventually will end up in the aquatic media (rivers and sea). For this reason, analytical techniques such as liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS) have become prominent to identify and quantify pharmaceuticals residues in aquatic matrices. In view of the scarce data on the occurrence of pharmaceuticals used as COVID-19 treatment, the aim of the present study was to evaluate the presence of these class of pharmaceuticals in river water which were dexamethasone, prednisone, ciprofloxacin, levofloxacin, remdesivir, ritonavir, lopinavir, acetaminophen, hydroxychloroquine, chloroquine and cloperastine, their toxicity in the aquatic environment using D. magna and to perform an exhaustive risk assessment in seven points of the Llobregat river basin. Dexamethasone, cloperastine and acetaminophen were the pharmaceuticals with higher concentrations, showing mean levels between 313 and 859 ng L−1.

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“…Based on the World Health Organization pain ladder, paracetamol was considered the first-line antipyretic and analgesic for COVID-19 patients, with WHO recommending it instead of ibuprofen if specific symptoms of COVID-19 were present. These recommendations might be due to the potential protective effect against infection with SARS-CoV-2 that paracetamol is considered to possess [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Self-Medication in Rural Northeastern Romania: Patients’ Attitudes and Habits

Rusu

Ababei

Bild

et al. 2022

IJERPH

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In recent years, many healthcare systems, along with healthcare professionals, have provided services in a patient-centered manner, in which patients are key actors in the care process. Encouraging self-care creates responsible patients, but it must be practiced responsibly. This study aims to analyze the tendency towards self-medication for patients from a rural area in Northeastern Romania. Data were collected using a questionnaire, which consisted of 25 questions, that has been developed by the research team. Student’s T test or one-way ANOVA was used, and the reliability of the questionnaire was calculated using Cronbach’s alpha coefficient. Fifty-eight patients agreed to participate and were interviewed. The results of the study suggest that respondents practice self-medication, which they resort to when their condition cannot be treated with natural remedies or herbs and when it impairs their ability to do their daily activities. Self-medication could be explained by the lack of self-care services as well as the trust patients have in the specific treatment. Patients prefer asking the pharmacist for drugs instead of visiting a physician, which could be due to higher accessibility and time-efficiency, while also being prone to stock up on certain medications due to limited access to healthcare.

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Egyptian perspectives on potential risk of paracetamol/acetaminophen-induced toxicities: Lessons learnt during COVID-19 pandemic

Cited by 29 publications

References 48 publications

Confusoside from Anneslea fragrans Alleviates Acetaminophen-Induced Liver Injury in HepG2 via PI3K-CASP3 Signaling Pathway

Confusoside from Anneslea fragrans Alleviates Acetaminophen-Induced Liver Injury in HepG2 via PI3K-CASP3 Signaling Pathway

Presence and toxicity of drugs used to treat SARS-CoV-2 in Llobregat River, Catalonia, Spain

Self-Medication in Rural Northeastern Romania: Patients’ Attitudes and Habits

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