Paracetamol self-poisoning: when oral N-acetylcysteine saves life? a case report

Benlamkaddem, Said; Iken, Imane; Houari, Nawfal; Abderrahim, E.; Boukatta, Brahim; Sbai, Hicham; Achour, Sanae; Kanjaa, Nabil

doi:10.11604/pamj.2018.29.83.10595

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…In Morocco, paracetamol can be purchased at a pharmacy without a prescription. As in other countries, a high percentage of analgesics and nonsteroidal anti-inflammatory drugs are used in drug overdoses [ 14 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Profile of Drug Overdose Reported in South-East Morocco from 2004 to 2016

Azekour

Belamalem

Soulaymani

et al. 2019

Drugs - Real World Outcomes

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BackgroundDrug overdose, either accidental or intentional, is the most common cause of acute poisoning worldwide.ObjectiveThe aim of this study was to determine the epidemiological profile of drug poisoning recorded in the south east of Morocco and to identify the proportion of intentional versus accidental drug overdose.MethodsThis was an epidemiological study of 180 cases of medicinal poisoning registered with the Provincial Delegation of Health in Errachidia between January 2004 and December 2016. Information on demographic and drug overdose characteristics was obtained from the regional poison center. Drugs were categorized according to the anatomical therapeutic chemical (ATC) classification system.ResultsAdults were the most affected group, with a median age of 21 years and a sex ratio of three females to every male. Drug poisoning mainly occurred in urban areas (83% of cases). Regarding clinical signs, 55.2% of patients presented with digestive signs and 27.6% with neurological signs. Other signs were also present: respiratory (5.1%), combined neurological and digestive (4.5%), cardiovascular (3.8%), and general (3.8%). Women represented 88.9% of those who had intentionally overdosed and 64.3% of those who had unintentionally overdosed. Benzodiazepine derivatives and other related drugs were involved in 21.5% of cases of drug poisoning, with other drugs found in patients with drug overdose as follows: paracetamol 3.3%, ethinyl estradiol/levonorgestrel 5%, and cyproheptadine 1.6%.ConclusionOur results indicate that the number of reported cases of drug poisoning in south-east Morocco increased between 2004 and 2016. The intentional use of drugs in overdose was mostly among adults, especially women. The drugs involved were predominantly psycholeptic drugs, followed by analgesics. Mortality was low, but investigation in a representative sample will show the real severity and outcomes of drug overdoses.

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Section: Discussionmentioning

confidence: 99%

Epidemiological Profile of Drug Overdose Reported in South-East Morocco from 2004 to 2016

Azekour

Belamalem

Soulaymani

et al. 2019

Drugs - Real World Outcomes

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“…It is useful as a mucolytic agent for the treatment of chronic bronchitis and other pulmonary diseases complicated by the production of viscous mucus [ 64 ]. It is also used as an antidote to paracetamol (acetaminophen) poisoning [ 65 ]. Although the therapeutic properties of NAC have been known for over half a century, subsequent scientific reports indicate an increasingly wider spectrum of its pharmacological activity.…”

Section: Nac As a Drug For Covid-19 Treatmentmentioning

confidence: 99%

Reactive Sulfur Compounds in the Fight against COVID-19

et al. 2022

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The SARS-CoV-2 coronavirus pandemic outbreak in 2019 resulted in the need to search for an effective and safe strategy for treating infected patients, relieving symptoms, and preventing severe disease. SARS-CoV-2 is an RNA virus that can cause acute respiratory failure and thrombosis, as well as impair circulatory system function. Permanent damage to the heart muscle or other cardiovascular disorders may occur during or after the infection. The severe course of the disease is associated with the release of large amounts of pro-inflammatory cytokines. Due to their documented anti-inflammatory, antioxidant, and antiviral effects, reactive sulfur compounds, including hydrogen sulfide (H2S), lipoic acid (LA), N-acetylcysteine (NAC), glutathione (GSH), and some other lesser-known sulfur compounds, have attracted the interest of scientists for the treatment and prevention of the adverse effects of diseases caused by SARS-CoV-2. This article reviews current knowledge about various endogenous or exogenous reactive sulfur compounds and discusses the possibility, or in some cases the results, of their use in the treatment or prophylaxis of COVID-19.

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“…Thus, we chose N-acetylcys-teine to continue the study, considering significant clinical experience using this drug as an antidote to revert hepatotoxicity of other drugs such as acetaminophen. [12][13][14]…”

Section: Hepatoprotector Selectionmentioning

confidence: 99%

“…10,11 This work aimed to enhance nimesulide safety profile through the association with a hepatoprotective agent. We tested three different candidates in vitro: N-acetylcysteine (potent antioxidant and glutathione precursor, well known as an antidote to hepatic intoxication related to other drugs), [12][13][14] L-carnitine (a mitochondrial function enhancer), 15,16 and Ginkgo biloba extract (selected due to its natural antioxidant effects). 17,18 After the selection of the best candidate in the in vitro challenge, we performed an in vivo study.…”

Section: Introductionmentioning

confidence: 99%

N-acetylcysteine+nimesulide: An association strategy aiming to prevent nimesulide-induced hepatotoxicity

Elias

Silva

Klein

et al. 2021

BJHBS

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Introduction: Nimesulide is a potent anti-inflammatorywith rapid and long-lasting effects, but also with a high riskof hepatotoxicity. Objective: This work aimed to preventnimesulide-induced hepatotoxicity through the associationof nimesulide with a hepatoprotective agent. Materials andMethods: First, we tested three hepatoprotective agents:N-acetylcysteine, L-carnitine, and Gingko biloba extract inan in vitro hepatic cell model. Both N-acetylcysteine and G.biloba showed promisor results. We selected N-acetylcysteineto continue the studies in an animal model. In vivo study wasperformed using male Wistar rats divided in 4 groups: control,nimesulide (100mg/kg/day), nimesulide (100mg/kg/day) +N-acetylcysteine (100mg/kg/day) and N-acetylcysteine alone(100mg/kg/day). Treatments were given by gavage, daily, for15 days. Results: Animals receiving nimesulide alone showedlower body weight gain compared to control. Body weightgain in the nimesulide + N-acetylcysteine group was higherthan nimesulide alone, evidencing lower toxicity. However,the body weight gain of the nimesulide + N-acetylcysteinegroup was still lower than the control animals. Animals treatedwith nimesulide alone presented an increased relative mass ofheart, liver, and spleen and significant hepatic damage seen inmicroscopy when compared to other groups. N-acetylcysteineco-administered with nimesulide prevented the increasedheart mass, but the same was not true with liver and spleen.Conclusions: This work evidence partial protection elicitedby the association of N-acetylcysteine and nimesulide againstnimesulide-induced hepatotoxicity.

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Paracetamol self-poisoning: when oral N-acetylcysteine saves life? a case report

Cited by 5 publications

References 9 publications

Epidemiological Profile of Drug Overdose Reported in South-East Morocco from 2004 to 2016

Epidemiological Profile of Drug Overdose Reported in South-East Morocco from 2004 to 2016

Reactive Sulfur Compounds in the Fight against COVID-19

N-acetylcysteine+nimesulide: An association strategy aiming to prevent nimesulide-induced hepatotoxicity

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