title: N-Acetylcysteine Use in Non-Acetaminophen-Induced Acute Liver Failure.
abstract: This article will review the available evidence related to the management of non-acetaminophen induced acute liver failure with N-acetylcysteine. Randomized controlled trials and a meta-analysis were included in this review. The efficacy of N-acetylcysteine in the treatment of acute liver failure from causes other than acetaminophen toxicity was evaluated. The efficacy of N-acetylcysteine in non-acetaminophen-induced acute liver failure is limited to specific patient populations. Patients classified as Coma Grade I or II are more likely to benefit from the use of this agent. The use of N-acetylcysteine is associated with improved transplant-free survival, not overall survival, in adults. N-Acetylcysteine does not improve the overall survival of patients with non-acetaminophen-induced acute liver failure but may be beneficial in those patients with Coma Grades I-II. Liver transplantation remains the only definitive therapy in advanced disease.
authors.affiliation: Department of Pharmacy Services, University of Louisville Hospital, Louisville, Kentucky (Drs McPheeters and VanArsdale); and Department of Pharmacy Services, Medical University of South Carolina, Charleston (Dr Weant).
authors.forename: Chelsey M
authors.initials: CM
authors.lastname: McPheeters
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: VanArsdale
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Weant
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D006801:Humans; D017114:Liver Failure, Acute / Q000188:drug therapy*; D016031:Liver Transplantation; D018579:Patient Selection; D016019:Survival Analysis
chemical_list: D000111:Acetylcysteine