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Clinical Toxicology Volume 52, 2014 - Issue 5
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Research Article

A single-arm clinical trial of a 48-hour intravenous N-acetylcysteine protocol for treatment of acetaminophen poisoning

K. HeardRocky Mountain Poison and Drug Center, Denver, CO, USA;Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USACorrespondence[email protected]
,
B. H. RumackDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA;Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
,
J. L. GreenRocky Mountain Poison and Drug Center, Denver, CO, USA;Vanderbilt University School of Nursing, Nashville, TN, USA
,
B. Bucher-BartelsonRocky Mountain Poison and Drug Center, Denver, CO, USA;University of Colorado School of Public Health, Aurora, CO, USA
,
S. HeardRocky Mountain Poison and Drug Center, Denver, CO, USA
,
A. C. BronsteinRocky Mountain Poison and Drug Center, Denver, CO, USA;Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
&
R. C. DartRocky Mountain Poison and Drug Center, Denver, CO, USA;Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
 show all
Pages 512-518 | Received 28 Oct 2013, Accepted 02 Mar 2014, Published online: 08 Apr 2014

References

  • Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Dart RC. 2010 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 28th Annual Report. Clin Toxicol (Phila) 2011; 49:910–941.
  • Smilkstein MJ, Knapp GL, Kulig KW, Rumack BH. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985). N Engl J Med 1988; 319:1557–1562.
  • Whyte IM, Francis B, Dawson AH. Safety and efficacy of intravenous N-acetylcysteine for acetaminophen overdose: analysis of the Hunter Area Toxicology Service (HATS) database. Curr Med Res Opin 2007; 23:2359–2368.
  • Yarema MC, Johnson DW, Berlin RJ, Sivilotti ML, Nettel-Aguirre A, Brant RF, et al. Comparison of the 20-hour intravenous and 72-hour oral acetylcysteine protocols for the treatment of acute acetaminophen poisoning. Ann Emerg Med 2009; 54:606–614.
  • Acetylcysteine (Acetadote) for acetaminophen overdosage. Med Lett Drugs Ther 2005; 47:70–71.
  • Prescott LF, Park J, Ballantyne A, Adriaenssens P, Proudfoot AT. Treatment of paracetamol (acetaminophen) poisoning with N-acetylcysteine. Lancet 1977; 2:432–434.
  • Doyon S, Klein-Schwartz W. Hepatotoxicity despite early administration of intravenous N-acetylcysteine for acute acetaminophen overdose. Acad Emerg Med 2009;16:34–39.
  • Schwartz EA, Hayes BD, Sarmiento KF. Development of hepatic failure despite use of intravenous acetylcysteine after a massive ingestion of acetaminophen and diphenhydramine. Ann Emerg Med 2008; 54:421–423.
  • Wang GS, Monte A, Bagdure D, Heard K. Hepatic failure despite early acetylcysteine following large acetaminophen-diphenhydramine overdose. Pediatrics 2011;127:e1077–e1080.
  • Rumack BH, Bateman DN. Acetaminophen and acetylcysteine dose and duration: past, present and future. Clin Toxicol (Phila) 2012;50:91–98.
  • Woodhead JL, Howell BA, Yang Y, Harrill AH, Clewell HJ III, Andersen ME, et al. An analysis of N-acetylcysteine treatment for acetaminophen overdose using a systems model of drug- induced liver injury. J Pharmacol Exp Ther 2012; 342: 529–540.
  • Smilkstein MJ, Bronstein AC, Linden C, Augenstein WL, Kulig KW, Rumack BH. Acetaminophen overdose: a 48-hour intravenous N-acetylcysteine treatment protocol. Ann Emerg Med 1991; 20:1058–1063.
  • Kerr F, Dawson A, Whyte IM, Buckley N, Murray L, Graudins A, et al. The Australasian Clinical Toxicology Investigators Collaboration randomized trial of different loadinginfusionrates of N-acetylcysteine. Ann Emerg Med 2005; 45:402–408.
  • Yang R, Miki K, He X, Killeen ME, Fink MP. Prolonged treatment with N-acetylcystine delays liver recovery from acetaminophen hepatotoxicity. Crit Care 2009; 13:R55.
  • Prescott LF. Treatment of severe acetaminophen poisoning with intravenous acetylcysteine. Arch Intern Med 1981; 141:386–389.
  • Pakravan N, Waring WS, Sharma S, Ludlam C, Megson I, Bateman DN. Risk factors and mechanisms of anaphylactoid reactions to acetylcysteine in acetaminophen overdose. Clin Toxicol (Phila). 2008; 46:697–702.
  • Lynch RM, Robertson R. Anaphylactoid reactions to intravenous N-acetylcysteine: a prospective case controlled study. Accid Emerg Nurs. 2004; 12:10–15.
  • Bateman DN, Dear JW, Thanacoody HK, Thomas SH, Eddleston M, Sandilands EA, et al. Reduction of adverse effects from intravenous acetylcysteine treatment for paracetamol poisoning: a randomised controlled trial. Lancet 2013.
  • Dart RC, Rumack BH. Patient-tailored acetylcysteine administration. Ann Emerg Med 2007; 50:280–281.
  • Tsai CL, Chang WT, Weng TI, Fang CC, Walson PD. A patient- tailored N-acetylcysteine protocol for acute acetaminophen intoxication. Clin Ther 2005; 27:336–341.

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