Annals of Emergency Medicine
Volume 54, Issue 4 , Pages 615-617 , October 2009

Is the Oral Acetylcysteine Protocol the Best Treatment for Late-Presenting Acetaminophen Poisoning?

  • G. Randall Bond, MD

      Affiliations

    • Corresponding Author InformationAddress for correspondence: G. Randall Bond, MD, CCHMC Emerg Med, 3333 Burnet Ave, ML 2008, Cincinnati, OH 45229; 513-233-9294, fax 513-636-2988

References 

  1. Yarema MC, Johnson DW, Berlin RJ, 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
  2. Schmidt LE, Dahlhoff K. Concomitant overdosing of other drugs in patient with paracetamol poisoning. Br J Clin Pharmacol. 2001;53:535–541
  3. Dart RC, Rumack BH. Patient-tailored acetylcysteine administration. Ann Emerg Med. 2007;50:280–288
  4. Betten DP, Cantrell FL, Thomas SC, et al. A prospective evaluation of shortened course oral N-acetylcysteine for the treatment of acute acetaminophen poisoning. Ann Emerg Med. 2007;50:272–279
  5. Tsai CL, Chang WT, Weng TI, et al. A patient-tailored N-acetylcysteine protocol for acute acetaminophen intoxication. Clin Ther. 2005;27:336–341
  6. Heard KJ. Acetylcysteine for acetaminophen poisoning. N Engl J Med. 2008;359:285–292
  7. Keays R, Harrison PM, Wendon JA, et al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial. BMJ. 1991;303:1026–1029
  8. Harrison PM, Wendon JA, Gimson AES, et al. Improvement by acetylcysteine of hemodynamics and oxygen transport in fulminant hepatic failure. N Engl J Med. 1991;324:1852–1857
  9. Kortsalioudaki C, Taylor RM, Cheeseman P, et al. Safety and efficacy of N-acetylcysteine in children with non-acetaminophen-induced acute liver failure. Liver Transpl. 2008;14:25–30
  10. Doyon S, Klein-Schwartz W. Hepatotoxicity despite early administration of intravenous N-acetylcysteine for acute acetaminophen overdose. Acad Emerg Med. 2009;16:34–39
  11. Buckley NA, Whyte IM, O'Connell DL, et al. Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning?. Clin Toxicol. 1999;37:759–767

 Supervising editor: E. Martin Caravati, MD, MPH

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The author has stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication date: Available online August 21, 2009.

 Reprints not available from the author.

PII: S0196-0644(09)01256-6

doi: 10.1016/j.annemergmed.2009.07.011

Annals of Emergency Medicine
Volume 54, Issue 4 , Pages 615-617 , October 2009

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