INTRODUCTION: We sought to compare antiemetic use after acetaminophen poisoning in patients treated with oral or intravenous (IV) N-acetylcysteine (NAC). METHODS: Our retrospective chart review identified 20 orally treated patients and 17 IV-treated patients. For both groups, we calculated the total number of antiemetic doses given, their associated cost, and also determined parameters that correlated with antiemetic use. RESULTS: IV-treated patients received fewer total antiemetic doses than those receiving oral NAC (1.1 0.2 vs. 2.8 0.7; P 0.04). Antiemetic cost correlated with doses received for both groups; however, because the regression lines differed (P 0.02), antiemetic therapy cost was less in IV-treated patients. In addition, serum acetaminophen concentration correlated with total antiemetic doses in oral NAC patients (P 0.002) but not with IV treatment patients (P 0.78). CONCLUSIONS: Intravenous NAC reduced antiemetic utilization, and it costs less than oral therapy. Furthermore, antiemetic use appeared to be determined by a combination of acetaminophen concentration and NAC administration route.
INTRODUCTION: We sought to compare antiemetic use after acetaminophenpoisoning in patients treated with oral or intravenous (IV) N-acetylcysteine (NAC). METHODS: Our retrospective chart review identified 20 orally treated patients and 17 IV-treated patients. For both groups, we calculated the total number of antiemetic doses given, their associated cost, and also determined parameters that correlated with antiemetic use. RESULTS: IV-treated patients received fewer total antiemetic doses than those receiving oral NAC (1.1 0.2 vs. 2.8 0.7; P 0.04). Antiemetic cost correlated with doses received for both groups; however, because the regression lines differed (P 0.02), antiemetic therapy cost was less in IV-treated patients. In addition, serum acetaminophen concentration correlated with total antiemetic doses in oral NACpatients (P 0.002) but not with IV treatment patients (P 0.78). CONCLUSIONS: Intravenous NAC reduced antiemetic utilization, and it costs less than oral therapy. Furthermore, antiemetic use appeared to be determined by a combination of acetaminophen concentration and NAC administration route.
Authors: Laura P James; Pippa M Simpson; Henry C Farrar; Gregory L Kearns; Gary S Wasserman; Jeffrey L Blumer; Michael D Reed; Janice E Sullivan; Jack A Hinson Journal: J Clin Pharmacol Date: 2005-10 Impact factor: 3.126
Authors: Darren Braude; Tricia Soliz; Cameron Crandall; Greg Hendey; James Andrews; Lori Weichenthal Journal: Am J Emerg Med Date: 2006-03 Impact factor: 2.469
Authors: Louise W Kao; Mark A Kirk; R Brent Furbee; Nimish H Mehta; Jason R Skinner; Edward J Brizendine Journal: Ann Emerg Med Date: 2003-12 Impact factor: 5.721