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Clinical Research

Fewer adverse effects with a modified two-bag acetylcysteine protocol in paracetamol overdose

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Pages 618-621 | Received 13 Sep 2017, Accepted 16 Nov 2017, Published online: 08 Dec 2017

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Annabelle S Chidiac, Nicholas A Buckley, Firouzeh Noghrehchi & Rose Cairns. (2023) Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease. Expert Opinion on Drug Metabolism & Toxicology 19:5, pages 297-317.
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Matthew Stanton, Ryan Feldman & David Gummin. (2023) Excess baggage in describing acetylcysteine regimens. Clinical Toxicology 61:1, pages 88-89.
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Slobodan M. Janković. (2022) Acetaminophen toxicity and overdose: current understanding and future directions for NAC dosing regimens. Expert Opinion on Drug Metabolism & Toxicology 18:11, pages 745-753.
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Naura Syafira, Andis Graudins, Mark Yarema & Anselm Wong. (2022) Comparing development of liver injury using the two versus three bag acetylcysteine regimen despite early treatment in paracetamol overdose. Clinical Toxicology 60:4, pages 478-485.
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Kevin Burnham, Tianrui Yang, Haleigh Smith & Steven Knight. (2021) A review of alternative intravenous acetylcysteine regimens for acetaminophen overdose. Expert Review of Clinical Pharmacology 14:10, pages 1267-1278.
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Alaa Daoud, Kim Peder Dalhoff, Mikkel Bring Christensen, Søren Bøgevig & Tonny Studsgaard Petersen. (2020) Two-bag intravenous N-acetylcysteine, antihistamine pretreatment and high plasma paracetamol levels are associated with a lower incidence of anaphylactoid reactions to N-acetylcysteine. Clinical Toxicology 58:7, pages 698-704.
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Michael A. Downes, Colin B. Page, Ingrid Berling, Ian M. Whyte & Geoffrey K. Isbister. (2020) Use of a tablet-based application for clinical handover and data collection. Clinical Toxicology 58:7, pages 692-697.
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Michael E. Mullins, Mary Yu, Lauren O’Grady, Shariq Khan & Evan S. Schwarz. (2020) Adverse reactions in patients treated with the one-bag method of N-acetylcysteine for acetaminophen ingestion. Toxicology Communications 4:1, pages 49-54.
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Anselm Wong, Natalie Homer, James W. Dear, Kay Weng Choy, James Doery & Andis Graudins. (2019) Paracetamol metabolite concentrations following low risk overdose treated with an abbreviated 12-h versus 20-h acetylcysteine infusion. Clinical Toxicology 57:5, pages 312-317.
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Christopher Hoyte & Richard C. Dart. (2019) Transition to two-bag intravenous acetylcysteine for acetaminophen overdose: a poison center’s experience . Clinical Toxicology 57:3, pages 217-218.
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Lars E. Schmidt, Ditlev N. Rasmussen, Tonny S. Petersen, Ines M. Macias-Perez, Leo Pavliv, Byron Kaelin, Richard C. Dart & Kim Dalhoff. (2018) Fewer adverse effects associated with a modified two-bag intravenous acetylcysteine protocol compared to traditional three-bag regimen in paracetamol overdose. Clinical Toxicology 56:11, pages 1128-1134.
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Elie Harmouche, Robert S. Hoffman & Mary Ann Howland. (2018) In response to: fewer adverse effects with a modified two-bag acetylcysteine protocol in paracetamol overdose. Clinical Toxicology 56:10, pages 907-908.
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Articles from other publishers (11)

Dae Won Park, Hyelin Jeon, Jeong Eun Kwon, Young Geun Lee, Rina So, Tae Hwan Choe, Yong Joon Jeong & Se Chan Kang. (2020) Hepatoprotective effect of Centella asiatica 50% ethanol extract against acetaminophen-induced acute liver injury in BALB/c mice. Toxicological Research 37:2, pages 261-275.
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Nadia I. Awad, Ann-Jeannette Geib, Akshay Roy, Craig Cocchio & Patrick J. Bridgeman. (2020) Protocol deviations in intravenous acetylcysteine therapy for acetaminophen toxicity. The American Journal of Emergency Medicine 38:4, pages 830-833.
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Anselm Wong, Kennon Heard, Andis Graudins, Richard Dart & Marco L. A. Sivilotti. (2020) Adducts Post Acetaminophen Overdose Treated with a 12-Hour vs 20-Hour Acetylcysteine Infusion. Journal of Medical Toxicology 16:2, pages 188-194.
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Angela L Chiew, David Reith, Adam Pomerleau, Anselm Wong, Katherine Z Isoardi, Jessamine Soderstrom & Nicholas A Buckley. (2019) Updated guidelines for the management of paracetamol poisoning in Australia and New Zealand. Medical Journal of Australia 212:4, pages 175-183.
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Anselm Wong, Geoff Isbister, Richard McNulty, Katherine Isoardi, Keith Harris, Angela Chiew, Shaun Greene, Naren Gunja, Nicholas Buckley, Colin Page & Andis Graudins. (2020) Efficacy of a two bag acetylcysteine regimen to treat paracetamol overdose (2NAC study). EClinicalMedicine 20, pages 100288.
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Xingyao Long, Jiajia Song, Xin Zhao, Yu Zhang, Hongwei Wang, Xinqi Liu & Huayi Suo. (2019) Silkworm pupa oil attenuates acetaminophen‐induced acute liver injury by inhibiting oxidative stress‐mediated NF‐κB signaling. Food Science & Nutrition 8:1, pages 237-245.
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A Wong, C Nejad, M Gantier, KW Choy, James Doery & A Graudins. (2019) MicroRNA from a 12-h versus 20-h acetylcysteine infusion for paracetamol overdose. Human & Experimental Toxicology 38:6, pages 646-654.
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Angela L. Chiew & Nicholas A. Buckley. (2019) SNAP – A Large Step in the Move towards Personalised Dosing of Acetylcysteine. EClinicalMedicine 11, pages 3-4.
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Hong-Chao Zhou, Hui Wang, Kun Shi, Jian-Ming Li, Ying Zong & Rui Du. (2018) Hepatoprotective Effect of Baicalein Against Acetaminophen-Induced Acute Liver Injury in Mice. Molecules 24:1, pages 131.
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Mark Yarema, Puja Chopra, Marco L. A. Sivilotti, David Johnson, Alberto Nettel-Aguirre, Benoit Bailey, Charlemaigne Victorino, Sophie Gosselin, Roy Purssell, Margaret Thompson, Daniel Spyker & Barry Rumack. (2018) Anaphylactoid Reactions to Intravenous N-Acetylcysteine during Treatment for Acetaminophen Poisoning. Journal of Medical Toxicology 14:2, pages 120-127.
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Tom MunyerAmberly Johnson. 2017. PharmacotherapyFirst: A Multimedia Learning Resource. PharmacotherapyFirst: A Multimedia Learning Resource.

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