Literature DB >> 20524832

A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose.

Vikhyat S Bebarta1, Louise Kao, Blake Froberg, Richard F Clark, Eric Lavonas, Ming Qi, Joao Delgado, John McDonagh, Tom Arnold, Oladapo Odujebe, Gerry O'Malley, Claudia Lares, Elizabeth Aguilera, Richard Dart, Kennon Heard, Chriss Stanford, Jamie Kokko, Greg Bogdan, Carrie Mendoza, Sara Mlynarchek, Sean Rhyee, Jason Hoppe, William Haur, Hock Heng Tan, Nguyen Nguyen Tran, Shawn Varney, Amy Zosel, Jennifer Buchanan, Mohammed Al-Helial.   

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.

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Year:  2010        PMID: 20524832      PMCID: PMC2894984          DOI: 10.3109/15563650.2010.486381

Source DB:  PubMed          Journal:  Clin Toxicol (Phila)        ISSN: 1556-3650            Impact factor:   4.467


  16 in total

Review 1.  Interventions for paracetamol (acetaminophen) overdose.

Authors:  J Brok; N Buckley; C Gluud
Journal:  Cochrane Database Syst Rev       Date:  2006-04-19

2.  Patient-tailored acetylcysteine administration.

Authors:  Richard C Dart; Barry H Rumack
Journal:  Ann Emerg Med       Date:  2007-04-05       Impact factor: 5.721

3.  A prospective evaluation of shortened course oral N-acetylcysteine for the treatment of acute acetaminophen poisoning.

Authors:  David P Betten; F Lee Cantrell; Stephen C Thomas; Saralyn R Williams; Richard F Clark
Journal:  Ann Emerg Med       Date:  2007-01-08       Impact factor: 5.721

4.  The Australasian Clinical Toxicology Investigators Collaboration randomized trial of different loading infusion rates of N-acetylcysteine.

Authors:  Fergus Kerr; Andrew Dawson; Ian M Whyte; Nicholas Buckley; Lindsay Murray; Andis Graudins; Betty Chan; Barbara Trudinger
Journal:  Ann Emerg Med       Date:  2005-04       Impact factor: 5.721

5.  Efficacy of oral versus intravenous N-acetylcysteine in acetaminophen overdose: results of an open-label, clinical trial.

Authors:  H E Perry; M W Shannon
Journal:  J Pediatr       Date:  1998-01       Impact factor: 4.406

6.  Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985)

Authors:  M J Smilkstein; G L Knapp; K W Kulig; B H Rumack
Journal:  N Engl J Med       Date:  1988-12-15       Impact factor: 91.245

7.  Intravenous administration of oral N-acetylcysteine.

Authors:  L Yip; R C Dart; K M Hurlbut
Journal:  Crit Care Med       Date:  1998-01       Impact factor: 7.598

8.  Lower incidence of anaphylactoid reactions to N-acetylcysteine in patients with high acetaminophen concentrations after overdose.

Authors:  W Stephen Waring; Alexandra F Stephen; Oliver D Robinson; Margaret A Dow; Janice M Pettie
Journal:  Clin Toxicol (Phila)       Date:  2008-07       Impact factor: 4.467

9.  Adverse reactions to intravenous N-acetylcysteine in Chinese patients with paracetamol (acetaminophen) poisoning.

Authors:  T Y Chan; J A Critchley
Journal:  Hum Exp Toxicol       Date:  1994-08       Impact factor: 2.903

10.  Acetaminophen overdose. 662 cases with evaluation of oral acetylcysteine treatment.

Authors:  B H Rumack; R C Peterson; G G Koch; I A Amara
Journal:  Arch Intern Med       Date:  1981-02-23
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  18 in total

1.  Evaluation of an Alternative Intravenous N-Acetylcysteine Regimen in Pediatric Patients.

Authors:  Kathryn A Pauley; Tracy L Sandritter; Jennifer A Lowry; D Adam Algren
Journal:  J Pediatr Pharmacol Ther       Date:  2015 May-Jun

2.  Chlorogenic acid prevents acetaminophen-induced liver injury: the involvement of CYP450 metabolic enzymes and some antioxidant signals.

Authors:  Chun Pang; Yu-chen Sheng; Ping Jiang; Hai Wei; Li-li Ji
Journal:  J Zhejiang Univ Sci B       Date:  2015-07       Impact factor: 3.066

3.  Effects of treatment with enalapril on hepatotoxicity induced by acetaminophen in mice.

Authors:  Mariel R B Betto; Lais F Lazarotto; Tatiane T N Watanabe; David Driemeier; Carlos E Leite; Maria M Campos
Journal:  Naunyn Schmiedebergs Arch Pharmacol       Date:  2012-07-03       Impact factor: 3.000

Review 4.  Evidence for the changing regimens of acetylcysteine.

Authors:  Angela L Chiew; Geoffrey K Isbister; Stephen B Duffull; Nicholas A Buckley
Journal:  Br J Clin Pharmacol       Date:  2015-11-23       Impact factor: 4.335

5.  Oxidative stress as a therapeutic target in globoid cell leukodystrophy.

Authors:  Jacqueline A Hawkins-Salsbury; Elizabeth Y Qin; Adarsh S Reddy; Carole A Vogler; Mark S Sands
Journal:  Exp Neurol       Date:  2012-07-28       Impact factor: 5.330

6.  Effectiveness of N-acetylcysteine for preserving residual renal function in patients undergoing maintenance hemodialysis: multicenter randomized clinical trial.

Authors:  Farrokhlaga Ahmadi; Mahsa Abbaszadeh; Effat Razeghi; Sima Maziar; Simin Dashti Khoidaki; Mohammad Taghi Najafi; Mahboob Lessan-Pezeshki
Journal:  Clin Exp Nephrol       Date:  2016-05-20       Impact factor: 2.801

Review 7.  Novel acetylcysteine regimens for treatment of paracetamol overdose.

Authors:  W Stephen Waring
Journal:  Ther Adv Drug Saf       Date:  2012-12

Review 8.  Current and future directions in the treatment and prevention of drug-induced liver injury: a systematic review.

Authors:  Jonathan G Stine; James H Lewis
Journal:  Expert Rev Gastroenterol Hepatol       Date:  2015-12-25       Impact factor: 3.869

9.  A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae.

Authors:  Cathrine Lund; Per Drottning; Birgitte Stiksrud; Javad Vahabi; Marianne Lyngra; Ivind Ekeberg; Dag Jacobsen; Knut Erik Hovda
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2012-07-24       Impact factor: 2.953

10.  Oral and Intravenous Acetylcysteine for Treatment of Acetaminophen Toxicity: A Systematic Review and Meta-analysis.

Authors:  Jody L Green; Kennon J Heard; Kate M Reynolds; Donald Albert
Journal:  West J Emerg Med       Date:  2013-05
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