title: N-acetylcysteine regimens for paracetamol overdose: Time for a change?
abstract: Paracetamol overdose is one of the commonest pharmaceutical poisonings in the world. For nearly four decades, intravenous acetylcysteine regimens have been used to treat most patients successfully and prevent or mitigate hepatotoxicity. However, the rate of occurrence of adverse reactions to acetylcysteine is quite high, and there is a potential for these to be reduced. Recent studies show that distributing the loading-dose of acetylcysteine over the first few hours of treatment may decrease the incidence of adverse reactions. In addition, varying the duration of acetylcysteine administration may potentially benefit certain cohorts of poisoned patients, depending on their risk of developing hepatotoxicity.
authors.affiliation: Emergency and Austin Toxicology Service, Austin Hospital, Melbourne, Victoria, Australia.|Monash Emergency Research Collaborative, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: Anselm
authors.initials: A
authors.lastname: Wong
authors.affiliation: Monash Emergency Research Collaborative, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.|Monash Toxicology Service, Program of Emergency Medicine, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Andis
authors.initials: A
authors.lastname: Graudins
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000111:Acetylcysteine / Q000008:administration & dosage* / Q000009:adverse effects; D061605:Administration, Intravenous; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D000931:Antidotes / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D062787:Drug Overdose / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D006801:Humans; D015994:Incidence
chemical_list: D018712:Analgesics, Non-Narcotic; D000931:Antidotes; D000082:Acetaminophen; D000111:Acetylcysteine
keywords: acetaminophen; acetylcysteine; antidote; poisoning