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Clinical Toxicology Volume 56, 2018 - Issue 11
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Clinical Research

Fewer adverse effects associated with a modified two-bag intravenous acetylcysteine protocol compared to traditional three-bag regimen in paracetamol overdose

Lars E. SchmidtRigshospitalet and Glostrup University Hospital, Copenhagen, Denmark; View further author information
,
Ditlev N. RasmussenHvidovre and Amager University Hospital, Copenhagen, Denmark; View further author information
,
Tonny S. PetersenBispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark; View further author information
,
Ines M. Macias-PerezCumberland Pharmaceuticals Inc., Nashville, Tennessee; View further author information
,
Leo PavlivCumberland Pharmaceuticals Inc., Nashville, Tennessee; View further author information
,
Byron KaelinCumberland Pharmaceuticals Inc., Nashville, Tennessee; View further author information
,
Richard C. DartRocky Mountain Poison and Drug Center, Denver, CO, USAView further author information
&
Kim DalhoffBispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark; Correspondence[email protected]
View further author information
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Pages 1128-1134 | Received 23 Feb 2018, Accepted 23 Apr 2018, Published online: 24 May 2018

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D. Nicholas Bateman, Richard C. Dart, James W. Dear, Laurie F. Prescott & Barry H. Rumack. (2023) Fifty years of paracetamol (acetaminophen) poisoning: the development of risk assessment and treatment 1973–2023 with particular focus on contributions published from Edinburgh and Denver. Clinical Toxicology 61:12, pages 1020-1031.
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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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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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Charlotte O’Callaghan, Andis Graudins & Anselm Wong. (2022) A two-bag acetylcysteine regimen is associated with shorter delays and interruptions in the treatment of paracetamol overdose. Clinical Toxicology 60:3, pages 319-323.
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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 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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Articles from other publishers (12)

Firouzeh Noghrehchi, Rose Cairns & Nicholas A Buckley. (2023) Hospital admissions for paracetamol poisoning declined following codeine re-scheduling in Australia. International Journal of Drug Policy 116, pages 104040.
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Matthew T. Stanton. (2022) Part II : Interactive case: Toxicology and poison control . JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 5:12, pages 1332-1337.
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Sasha K. Kaiser & Richard C. Dart. (2022) The Roles of Antidotes in Emergency Situations. Emergency Medicine Clinics of North America 40:2, pages 381-394.
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Angela L. Chiew & Nicholas A. Buckley. (2021) Acetaminophen Poisoning. Critical Care Clinics 37:3, pages 543-561.
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Lotte C.G. Hoegberg & Soeren Boegevig. (2021) Adverse effects from selected antidotes commonly used in poisonings. Adverse Drug Reaction Bulletin 327:1, pages 1267-1270.
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Nicole M Acquisto, Giles W Slocum, Matthew H Bilhimer, Nadia I Awad, Stephanie Baker Justice, Gregory F Kelly, Therese Makhoul, Asad E Patanwala, Gary D Peksa, Blake Porter, Donna M Shuler Truoccolo, Cierra N Treu, Kyle A Weant & Michael C Thomas. (2020) Key articles and guidelines for the emergency medicine clinical pharmacist: 2011-2018 update. American Journal of Health-System Pharmacy 77:16, pages 1284-1335.
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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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Robert S. Hoffman. (2020) Acetylcysteine for paracetamol: Will one size ever fit all?. EClinicalMedicine 20, pages 100314.
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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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Tom MunyerAmberly Johnson. 2017. PharmacotherapyFirst: A Multimedia Learning Resource. PharmacotherapyFirst: A Multimedia Learning Resource.

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