concept adminisrative

Jun 28th, 2015
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Abilene Christian University
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Sl.No. Entry Criteria 1 All test hardware platforms must have been successfully installed, configured and functioning properly. 2 All documents related to design (How it works ) must be made available. 3 All personnel involved in the system test effort must be trained in tools to be used during testing process.

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Tintinallis Emergency MedicineIntroductionAcetaminophenN-acetyl-p-aminophenolParacetamolAPAPErroneous beliefBenignThe victim was unaware that it was aningredient in the ingested preparation5% of all toxic exposure23% of reported fatalitiesPharmacology (1)Recommended dosageAdult 650~1000mg every 4 to 6hr, <4g/daychildren 10~15mg/kg every 4 to 6hrPeak serum levelTherapeutic doses: <30min~2hrOverdose: <2hPharmacology (2)MetabolizationSulfation (20~46%)Glucuronidation (40~67%)Renal elimination (<5%)Oxidization by cytochrome P450 ( 10%) CYP2E1, CYP1A2, CYP3A4 NAPQI (N-acetyl-p-benzoquinoneimine)Immediate hepatic injury(<12hr)Prolonged hepatic damageClinical Presentation (1)Four stage Stage 1 (the first 24hr) anorexia, nausea, vomiting, pallor, malaise Stage 2 (by day 2 to 3) RUQ pain & tenderness, abnormal laboratory tests (AST, ALT,bilirubin recover without sequelae Stage 3 (by day 3 to 4) some fulminant hepatic failure (metabolic acidosis, coagulopathy, renal failure, encephalopathy, GI symptoms Stage 4 Recovery from fulminant hepatic failure Complete resolution of hepatic dysfunctionClinical Presentation (2)Risk Factors Insufficient glutathione stores alcoholics, AIDS pt. cytochrome P450 enzymatic activity alcoholics, anticonvulsant, antituberculous mx.

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