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Clinical Toxicology Volume 54, 2016 - Issue 2
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Research Article

A prospective observational study of a novel 2-phase infusion protocol for the administration of acetylcysteine in paracetamol poisoning

Geoffrey K. IsbisterClinical Toxicology Research Group, University of Newcastle, Newcastle, Australia; ;Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle; Correspondence[email protected]
,
Michael A. DownesClinical Toxicology Research Group, University of Newcastle, Newcastle, Australia; ;Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle;
,
Kylie McnamaraDepartment of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle;
,
Ingrid BerlingClinical Toxicology Research Group, University of Newcastle, Newcastle, Australia; ;Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle;
,
Ian M. WhyteClinical Toxicology Research Group, University of Newcastle, Newcastle, Australia; ;Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle;
&
Colin B. PageClinical Toxicology Research Group, University of Newcastle, Newcastle, Australia; ;Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle; ;Emergency Department, Princess Alexandra Hospital, Queensland, Australia
Pages 120-126 | Received 22 Sep 2015, Accepted 27 Oct 2015, Published online: 22 Dec 2015

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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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Robert G. Hendrickson. (2019) What is the most appropriate dose of N-acetylcysteine after massive acetaminophen overdose?. Clinical Toxicology 57:8, pages 686-691.
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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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Richard McNulty, Jia Min Elizabeth Lim, Pramod Chandru & Naren Gunja. (2018) Fewer adverse effects with a modified two-bag acetylcysteine protocol in paracetamol overdose. Clinical Toxicology 56:7, pages 618-621.
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Regan A. Baum, Adam Dugan, Elise Metts, Kyle A. Weant, Abby M. Bailey & Scott Wilkie. (2018) Modified two step N-acetylcysteine dosing regimen for the treatment of acetaminophen overdose a safe alternative. Toxicology Communications 2:1, pages 81-84.
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Articles from other publishers (19)

Anna Licata, Maria Giovanna Minissale, Simona Stankevičiūtė, Judith Sanabria-Cabrera, Maria Isabel Lucena, Raul J Andrade & Piero Luigi Almasio. (2022) N-Acetylcysteine for Preventing Acetaminophen-Induced Liver Injury: A Comprehensive Review. Frontiers in Pharmacology 13.
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Bruno Mégarbane, Mathieu Oberlin, Jean-Claude Alvarez, Frederic Balen, Sébastien Beaune, Régis Bédry, Anthony Chauvin, Isabelle Claudet, Vincent Danel, Guillaume Debaty, Arnaud Delahaye, Nicolas Deye, Jean-Michel Gaulier, Francis Grossenbacher, Philippe Hantson, Frédéric Jacobs, Karim Jaffal, Magali Labadie, Laurence Labat, Jérôme Langrand, Frédéric Lapostolle, Philippe Le Conte, Maxime Maignan, Patrick Nisse, Philippe Sauder, Christine Tournoud, Dominique Vodovar, Sebastian Voicu, Pierre-Géraud Claret & Charles Cerf. (2020) Management of pharmaceutical and recreational drug poisoning. Annals of Intensive Care 10:1.
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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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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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Angela L. Chiew & Geoffrey K. Isbister. 2019. The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine. The Therapeutic Use of N-Acetylcysteine (NAC) in Medicine 147 168 .
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.
Crossref
C Reynard & L Howard. (2018) Bet 1: A slower rate of initial N-acetylcysteine infusion in the treatment of acute paracetamol overdose to reduce adverse reactions. Emergency Medicine Journal 35:3, pages 199.2-201.
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Lauren O'Grady, Michael E. Mullins & Evan S. Schwarz. (2017) A comment on ‘An assessment of the variation in the concentrations of acetylcysteine in infusions for the treatment of paracetamol overdose’. British Journal of Clinical Pharmacology 83:12, pages 2833-2834.
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Evan S. Schwarz, Michael E. Mullins & David Liss. (2017) When two is not better than one. British Journal of Clinical Pharmacology 83:10, pages 2310-2311.
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B. Mégarbane. (2017) Intoxication par le paracétamol : quoi de neuf ?Acetaminophen poisoning: What is new?. Médecine Intensive Réanimation 26:5, pages 383-395.
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Anselm Wong, Cornelia Landersdorfer & Andis Graudins. (2017) Pharmacokinetic modelling of modified acetylcysteine infusion regimens used in the treatment of paracetamol poisoning. European Journal of Clinical Pharmacology 73:9, pages 1103-1110.
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Tom MunyerAmberly Johnson. 2017. PharmacotherapyFirst: A Multimedia Learning Resource. PharmacotherapyFirst: A Multimedia Learning Resource.
Ingrid Berling, Ahmed Mostafa, Jeffrey E. Grice, Michael S. Roberts & Geoffrey K. Isbister. (2017) Warfarin Poisoning with Delayed Rebound Toxicity. The Journal of Emergency Medicine 52:2, pages 194-196.
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Anselm Wong & Andis Graudins. (2016) N-acetylcysteine regimens for paracetamol overdose: Time for a change?. Emergency Medicine Australasia 28:6, pages 749-751.
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George P. Bailey, Javad Najafi, Muhammad E. M. O. Elamin, W. Stephen Waring, Simon H. L. Thomas, John R. H. Archer, David M. Wood & Paul I. Dargan. (2016) Delays during the administration of acetylcysteine for the treatment of paracetamol overdose. British Journal of Clinical Pharmacology 82:5, pages 1358-1363.
Crossref
Simon Hugh Lynton Thomas. (2016) Paracetamol (acetaminophen) overdose: Are current recommendations for treatment with N-acetylcysteine satisfactory?. Toxicology Letters 258, pages S34-S35.
Crossref
Euan A. Sandilands, Emma E. Morrison & D. Nicholas Bateman. (2016) Adverse reactions to intravenous acetylcysteine in paracetamol poisoning. Adverse Drug Reaction Bulletin 297:1, pages 1147-1150.
Crossref
Ingrid Berling & Geoffrey K. Isbister. (2015) The Half RR Rule: A Poor Rule of Thumb and Not a Risk Assessment Tool for QT Interval Prolongation. Academic Emergency Medicine 22:10, pages 1139-1144.
Crossref

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