Cimetidine in the treatment of acetaminophen overdose.
Acetaminophen overdose is generally treated with oral N-acetylcysteine. While N-acetylcysteine is protective, an additional effective mode of treatment is desirable in large overdoses. A growing body of evidence suggests that cimetidine significantly reduces the hepatotoxicity of an acetaminophen overdose and that its hepatoprotective action may be additive to that of N-acetylcysteine. We report a case of acetaminophen overdose treated with oral N-acetylcysteine in conjunction with cimetidine by continuous i.v. infusion. The 4-h acetaminophen level was 410 micrograms/ml, and the highest measured level of serum glutamic oxaloacetic transaminase was 83 IU/L on day 3, indicating minimal hepatic toxicity.
Rolband
G C
GC
Department of Medicine, East Carolina University School of Medicine, Greenville 27858.
Marcuard
S P
SP
D000082:Acetaminophen / Q000506:poisoning*; D000111:Acetylcysteine / Q000627:therapeutic use; D000328:Adult; D002927:Cimetidine / Q000627:therapeutic use*; D062787:Drug Overdose / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans
D000082:Acetaminophen; D002927:Cimetidine; D000111:Acetylcysteine