Comparison of oral and i.v. acetylcysteine in the treatment of acetaminophen poisoning.

@article{Kanter2006ComparisonOO,
  title={Comparison of oral and i.v. acetylcysteine in the treatment of acetaminophen poisoning.},
  author={Michele Zell Kanter},
  journal={American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists},
  year={2006},
  volume={63 19},
  pages={
          1821-7
        }
}
  • M. Kanter
  • Published 2006
  • Medicine
  • American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
PURPOSE The efficacy, safety, and cost issues that should be considered when deciding on the appropriate route of acetylcysteine for the treatment of patients with acetaminophen poisoning are reviewed. SUMMARY Oral and i.v. acetylcysteine appear to be equally effective when given within 8-10 hours of acetaminophen overdose. Anaphylactoid reactions to i.v. acetylcysteine have generally been reported in 3-6% of acetaminophen-poisoned patients. Dosing errors and hyponatremia have occurred in… Expand
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Based on a retrospective review of the clinical use of oral and IV NAC in pediatric patients with APAP intoxication from June 1, 2004 through May 31, 2008, the majority of patients received recommended dosing of Nac therapy; however, 3 patients received extended NAC therapy. Expand
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Intravenous acetylcysteine for indications other than acetaminophen overdose.
  • S. Bass, Nathaniel R. Zook
  • Medicine
  • American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2013
TLDR
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Introduction Paracetamol is the most commonly used drug in deliberate poisoning. N-acetylcysteine is the standard antidote for significant acute paracetamol overdose, but the route of administrationExpand
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TLDR
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TLDR
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N-acetylcysteine overdose after acetaminophen poisoning
TLDR
Considering the similarity between some of the clinical symptoms of acetaminophen overdose and NAC overdose, it is vitally important for the administration phases and checking of the patient’s symptoms to be carried out attentively and cautiously. Expand
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TLDR
A shorter hospital stay, patient and doctor convenience, and the concerns over the reduction in bioavailability of oral N- acetylcysteine by charcoal and vomiting make intravenous N-acetylcy Steine preferable for most patients with acetaminophen poisoning. Expand
Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985)
TLDR
It is concluded that N-acetylcysteine treatment should be started within eight hours of an acetaminophen overdose, but that treatment is still indicated at least as late as 24 hours after ingestion, and it may be superior when treatment is delayed. Expand
Adverse reactions to N‐acetylcysteine during treatment for paracetamol poisoning
TLDR
N-acetylcysteine is an effective antidote and its toxicity is acceptable if patients are selected carefully for treatment on the basis of the time that has elapsed since the poisoning, and the blood concentrations of paracetamol. Expand
Oral or intravenous N-acetylcysteine for acetaminophen poisoning?
TLDR
Initial studies with intravenous N-acetylcysteine in the United Kingdom in 100 severely poisoned patients showed that, in comparison with 57 similarly poisoned control patients receiving only supportive therapy, it was virtually 100% effective in preventing severe liver damage, renal failure, and death, provided that it was given. Expand
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TLDR
In the dose that is recommended for the treatment of acute paracetamol poisoning, intravenous NAC is generally safe in Chinese but mild side effects are common and the initial loading dose is given over 60 rather than 15 min. Expand
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TLDR
Non-life-threatening anaphylactoid reactions to intravenous NAC are treated easily and the infusion may be continued or restarted safely after the administration of diphenhydramine, according to management guidelines developed. Expand
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TLDR
It appears that anaphylactoid reactions to intravenous N-acetylcysteine are more likely to occur in high-risk patients, when plasma paracetamol concentrations were found to be below the treatment lines and in late presenters. Expand
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TLDR
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TLDR
Exogenous N-acetylcysteine does not form significant amounts of conjugate with the reactive metabolite of acetaminophen in the rat in vivo but increases glutathione synthesis, thus providing more substrate for the detoxification of the reactive metabolismite in the early phase of an acetamophen intoxication when the critical reaction with vital macromolecules occurs. Expand
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TLDR
Intravenous acetylcysteine was more effective than cysteamine and methionine and noticeably free of adverse effects and is the treatment of choice for paracetamol poisoning. Expand
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