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 1 October 2006
  • Medicine, Biology
  • 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… 
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N-Acetylcysteine Overdose After Acetaminophen Poisoning
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A rare case of iatrogenic NAC overdose following an error in calculation of the prescribed dose is reported, where the patient became drowsy and developed decreased level of consciousness, stupor, repetitive intractable focal and generalized ‎convulsions, decrease visual acuity.
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  • Medicine, Biology
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Stability of a flavored formulation of acetylcysteine for oral administration.
  • R. Siden, Cary E. Johnson
  • Chemistry
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2008
TLDR
A flavored oral formulation of acetylcysteine 86.5 mg/mL was stable for at least 35 days when stored at room temperature and in the refrigerator in amber plastic bottles.
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References

SHOWING 1-10 OF 60 REFERENCES
Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning?
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.
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.
Oral or intravenous N-acetylcysteine for acetaminophen poisoning?
Adverse Reactions to intravenous N-Acetylcysteine in Chinese Patients with Paracetamol (Acetaminophen) Poisoning
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.
Anaphylactoid reactions to intravenous N-acetylcysteine: a prospective case controlled study.
Shorter duration of oral N-acetylcysteine therapy for acute acetaminophen overdose.
TLDR
It is suggested that a shorter course of oral NAC therapy in patients who do not show evidence of hepatotoxicity within 36 hours of an acute acetaminophen overdose is safe and effective.
Mechanism of action of N-acetylcysteine in the protection against the hepatotoxicity of acetaminophen in rats in vivo.
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.
Intravenous N-acetylcysteine: still the treatment of choice for paracetamol poisoning.
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.
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