Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Oct 2018
Case Reports[Metabolic Acidosis under Acetaminophen Intake - an Unordinary Side Effect].
Metabolic acidosis is common among hospitalized patients. However, in a few cases a long-term administration of acetaminophen can lead to transient 5-oxoproline accumulation and causes metabolic acidosis with high anion gap in adults. A 73-year-old man was hospitalized with Staph. aureus sepsis after right knee prosthesis infection and received analgesic treatment with acetaminophen 2 g/d and antibiotic therapy with flucloxacillin over several weeks. ⋯ A change in antibiotic treatment, interruption of acetaminophen and administration of acetylcysteine lead to a normalization of the acid-base balance. In a patient with metabolic acidosis under acetaminophen administration, particularly in the context of sepsis, malnutrition, liver and kidney diseases as well as antibiotic treatment with flucloxacillin an accumulation of 5-oxoproline must be considered. The treatment with acetaminophen must be interrupted and acetylcysteine should be administered.