Faculty Collaboration Database

A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose. Clin Toxicol (Phila) 2010 Jun;48(5):424-30

Date

06/08/2010

Pubmed ID

20524832

Pubmed Central ID

PMC2894984

DOI

10.3109/15563650.2010.486381

Scopus ID

2-s2.0-77954234433 (requires institutional sign-in at Scopus site)   56 Citations

Abstract

UNLABELLED: Oral and intravenous (IV) N-acetylcysteine (NAC) are used for the treatment of acetaminophen poisoning. The objective of this multicenter study was to compare the safety of these two routes of administration.

METHODS: We conducted a multicenter chart review of all patients treated with NAC for acetaminophen poisoning. The primary safety outcome was the percentage of patients with NAC-related adverse events.

RESULTS: A total of 503 subjects were included in the safety analysis (306 IV-only, 145 oral-only, and 52 both routes). There were no serious adverse events related to NAC for either route. Nausea and vomiting were the most common related adverse events and were more common with oral treatment (23 vs. 9%). Anaphylactoid reactions were more common with IV administration (6 vs. 2%).

CONCLUSIONS: IV and oral NAC are generally mild adverse drug reactions.

Author List

Bebarta VS, Kao L, Froberg B, Clark RF, Lavonas E, Qi M, Delgado J, McDonagh J, Arnold T, Odujebe O, O'Malley G, Lares C, Aguilera E, Dart R, Heard K, Stanford C, Kokko J, Bogdan G, Mendoza C, Mlynarchek S, Rhyee S, Hoppe J, Haur W, Tan HH, Tran NN, Varney S, Zosel A, Buchanan J, Al-Helial M

Author

Amy Elizabeth Zosel MD Associate Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acetaminophen
Acetylcysteine
Anaphylaxis
Drug Administration Routes
Drug Overdose
Humans
Infusions, Intravenous
Injections, Intravenous
Nausea
Safety
Treatment Outcome
Vomiting