TREATMENT OF PARACETAMOL (ACETAMINOPHEN) POISONING WITH N-ACETYLCYSTEINE

@article{Prescott1977TREATMENTOP,
  title={TREATMENT OF PARACETAMOL (ACETAMINOPHEN) POISONING WITH N-ACETYLCYSTEINE},
  author={Laurie F. Prescott and Alex. Ballantyne and Alex T. Proudfoot and J. Park and Peter Isadore Adriaenssens},
  journal={The Lancet},
  year={1977},
  volume={310},
  pages={432-434}
}

Treatment of severe acetaminophen poisoning with intravenous acetylcysteine.

TLDR
Intravenous IV administration is preferable, since nausea and vomiting may limit the effectiveness of oral therapy, and acetylcysteine was effective in preventing liver damage, hepatic failure, renal damage, and death when given eight to ten hours after poisoning.

N‐acetylcysteine regimens for paracetamol overdose: Time for a change?

TLDR
Recent studies show that distributing the loading‐dose of acetylcysteine over the first few hours of treatment may decrease the incidence of adverse reactions, and varying the duration ofacetylcy Steine administration may potentially benefit certain cohorts of poisoned patients, depending on their risk of developing hepatotoxicity.

N-Acetylcysteine in the Poisoned Patient

  • A. ChiewG. Isbister
  • Medicine, Biology
    The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine
  • 2018
TLDR
As NAC is the cornerstone of treatment in paracetamol poisoning, trials have mainly focused on optimising dose, duration, rate and route of administration, with the primary aim to decrease rates of adverse events, shorten treatment time and maintain efficacy.

Current issues with paracetamol induced toxicity

Paracetamol (acetaminophen; APAP), a commonly-used analgesic and anti-pyretic drug, is usually safe when administered at therapeutic doses in children. However, at overdoses, APAP has the potential

Effect of antidotal N-acetylcysteine on the pharmacokinetics of acetaminophen in dogs.

TLDR
Treatment with NAC enhanced the elimination of AP from the body as indicated by the decreased plasma half-life and higher elimination rate constant and changes in the area under plasma concentration curve data were associated with a 61% increase in total body clearance in Group I.

Oral or intravenous N-acetylcysteine for acetaminophen poisoning?

The disposition and kinetics of intravenous N-acetylcysteine in patients with paracetamol overdosage

TLDR
The dosage schedule for intravenous N-acetylcysteine should probably be modified since adverse reactions invariably occur early when plasma concentrations are at their highest, and liver damage was prevented just as effectively at the lowest as at the highest Cmax.

Acetylcysteine therapy for acetaminophen poisoning.

TLDR
The efficacy of acetylcysteine is accepted for the prevention of hepatic injury when administered early after acetaminophen overdose and prevents death when administered to patients with hepatic failure fromacetaminophen.

Pharmacokinetics of N‐acetylcysteine are altered in patients with chronic liver disease

Background: The threshold plasma paracetamol concentration at which N‐acetylcysteine (NAC) treatment is recommended to treat paracetamol poisoning in a patient with induced liver enzymes (for
...

References

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Patients developing hepatic necrosis following intoxication with paracetamol were classified as either ‘potentially induced’ or ‘non-induced’ according to their consumption during the previous 3

The Use of Cysteamine and Dimercaprol

TLDR
This study was undertaken in patients following paracetamol overdose to compare the protective effect of cysteamine with that of dimercaprol, another sulphydryl group donor, found to be of some protective effect in laboratory animals and which had the advantage of being commercially available for human use.

Paracetamol metabolism following overdosage: application of high performance liquid chromatography

TLDR
The pattern of urinary excretion of paracetamol metabolites did not appear to be influenced by the treatment given, but was related to the severity of liver damage (Table 1), which was significantly less in Patients with severe liver damage than in those without.

Acetaminophen-induced hepatic necrosis. IV. Protective role of glutathione.

TLDR
A fundamental role of glutathione in the body may be to protect tissues against electrophilic attack by drug metabolites and other alkylating agents.

Meconium ileus equivalent in adults with cystic fibrosis of pancreas: a report of six cases.

TLDR
Eleven episodes of "meconium ileus equivalent" have been seen in six adults with cystic fibrosis of the pancreas, and maintenance treatment with acetylcysteine may be necessary to prevent relapse.

Gas‐liquid chromatographic estimation of paracetamol

  • L. Prescott
  • Medicine
    The Journal of pharmacy and pharmacology
  • 1971