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The incidence of renal dysfunction is related to the severity of the acetaminophen ingestion * : Patients with liver involvement but no hepatic failure: ~5% Patients with severe poisoning:10% Patients with acute hepatic failure: ~50% Pathogenesis * Direct toxicity by toxic metabolites of APAP, oxidized by CYP in the kidney

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Elderly, Cachectic, or Debilitated Patients: Life-threatening respiratory depression is more likely to occur in elderly, cachectic, or debilitated patients because they may have altered pharmacokinetics or altered clearance compared to younger, healthier patients [see WARNINGS

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