Clinical outcome of massive acetaminophen overdose treated with standard-dose N-acetylcysteine
| Autor: | John W. Downs, Michelle Troendle, Brandon K. Wills, Kirk L. Cumpston, S. Rutherfoord Rose, Emily K. Kershner |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Poison Control Centers Time Factors acetaminophen overdose Adolescent Antidotes Toxicology Risk Assessment Drug Administration Schedule Acetylcysteine Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Humans Medicine 030212 general & internal medicine Dosing Infusions Intravenous Acetaminophen Retrospective Studies business.industry 030208 emergency & critical care medicine General Medicine Analgesics Non-Narcotic Treatment Outcome Anesthesia Female Chemical and Drug Induced Liver Injury Drug Overdose business medicine.drug |
| Zdroj: | Clinical Toxicology. 59:932-936 |
| ISSN: | 1556-9519 1556-3650 |
| DOI: | 10.1080/15563650.2021.1887493 |
| Popis: | Recent recognition of "massive" acetaminophen (APAP) overdoses has led to the question of whether standard dosing of N-acetylcysteine (NAC) is adequate to prevent hepatoxicity in these patients. The primary aim of this study was to evaluate the clinical outcome for patients with massive APAP overdose who received standard intravenous NAC dosing of 300 mg/kg over 21 h.This was a single-center retrospective cohort study conducted by chart review of APAP overdoses reported to a regional poison center from 1 January 2010 to 31 December 2019. Massive APAP overdose was defined by single, acute overdose resulting in an APAP concentration exceeding 300 mcg/mL at 4 h post-ingestion. Standard univariate statistical analysis was conducted to describe the cohort, and a multivariate logistic model was utilized to calculate adjusted odds ratios for risk of hepatoxicity.1425 cases of APAP overdose were reviewed. 104 cases met the inclusion criteria of massive APAP overdose. Overall, 79 cases (76%) had no acute liver injury or hepatotoxicity, and 25 (24%) developed hepatoxicity. Nine percent (Standard NAC dosing received within 8 h prevented hepatoxicity in 91% ( |
| Databáze: | OpenAIRE |
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