Safety and Effectiveness of Acetadote for Acetaminophen Toxicity

Whyte, Allyson J; Kehrl, Thompson; Brooks, Daniel E.; Katz, Kenneth D.; Sokolowski, Devin

doi:10.1016/j.jemermed.2008.05.007

Cited by 29 publications

(20 citation statements)

References 12 publications

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“…By using a potent antioxidant, N-acetyl-cysteine (NAC), we illustrated that plasma levels of I-FABP and tissue intestinal α-defensins and pro-inflammatory cytokines can bedimished, thus identifying oxidative stress as a possible mechanism for intestinal injury. Since NAC is a safe and effective treatment for acetaminophen toxicity [36] , our study provides a rationale to further investigate its use for the medical treatment of intestinal ischemia.…”

Section: Discussionmentioning

confidence: 99%

I-FABP as Biomarker for the Early Diagnosis of Acute Mesenteric Ischemia and Resultant Lung Injury

et al. 2014

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Acute mesenteric ischemia (AMI) is a life-threatening condition that can result in multiple organ injury and death. A timely diagnosis and treatment would have a significant impact on the morbidity and mortality in high-risk patient population. The purpose of this study was to investigate if intestinal fatty acid binding protein (I-FABP) and α-defensins can be used as biomarkers for early AMI and resultant lung injury. C57BL/6 mice were subjected to intestinal ischemia by occlusion of the superior mesenteric artery. A time course of intestinal ischemia from 0.5 to 3 h was performed and followed by reperfusion for 2 h. Additional mice were treated with N-acetyl-cysteine (NAC) at 300 mg/kg given intraperitoneally prior to reperfusion. AMI resulted in severe intestinal injury characterized by neutrophil infiltrate, myeloperoxidase (MPO) levels, cytokine/chemokine levels, and tissue histopathology. Pathologic signs of ischemia were evident at 1 h, and by 3 h of ischemia, the full thickness of the intestine mucosa had areas of coagulative necrosis. It was noted that the levels of α-defensins in intestinal tissue peaked at 1 h and I-FABP in plasma peaked at 3 h after AMI. Intestinal ischemia also resulted in lung injury in a time-dependent manner. Pretreatment with NAC decreased the levels of intestinal α-defensins and plasma I-FABP, as well as lung MPO and cytokines. In summary, the concentrations of intestinal α-defensins and plasma I-FABP predicted intestinal ischemia prior to pathological evidence of ischemia and I-FABP directly correlated with resultant lung injury. The antioxidant NAC reduced intestinal and lung injury induced by AMI, suggesting a role for oxidants in the mechanism for distant organ injury. I-FABP and α-defensins are promising biomarkers, and may guide the treatment with antioxidant in early intestinal and distal organ injury.

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Section: Discussionmentioning

confidence: 99%

I-FABP as Biomarker for the Early Diagnosis of Acute Mesenteric Ischemia and Resultant Lung Injury

et al. 2014

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“…However, acetaminophen overdose is common in patients who present to hospital emergency rooms, and in many cases causes liver and renal necrosis 1–3. Previous studies reported that a sterile 20% solution of N-acetylcysteine (NAC) administered intravenously was effective in the treatment of acetaminophen overdose 4–6.…”

Section: Introductionmentioning

confidence: 99%

N-acetylcysteine overdose after acetaminophen poisoning

Mahmoudi¹,

Astaraki²,

Mohtashami³

et al. 2015

IMCRJ

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N-acetylcysteine (NAC) is used widely and effectively in oral and intravenous forms as a specific antidote for acetaminophen poisoning. Here we report a rare case of iatrogenic NAC overdose following an error in preparation of the solution, and describe its clinical symptoms. Laboratory results and are presented and examined. A 23-year-old alert female patient weighing 65 kg presented to the emergency ward with weakness, lethargy, extreme fatigue, nausea, and dizziness. She had normal arterial blood gas and vital signs. An excessive dosage of NAC over a short period of time can lead to hemolysis, thrombocytopenia, and acute renal failure in patients with normal glucose-6-phosphate dehydrogenase, and finally to death. Considering the similarity between some of the clinical symptoms of acetaminophen overdose and NAC overdose, it is vitally important for the administration phases and checking of the patient’s symptoms to be carried out attentively and cautiously.

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“…La frecuencia de presentación de estas reacciones adversas varía en la mayor parte de estudios entre el 3% al 25% (35,36,44). Por vía oral los efectos se presentan a nivel gastrointestinal como náuseas y vómito.…”

Section: Manejo Específicounclassified

Intoxicación por acetaminofén

Mancipe¹,

2010

Rev. Med.

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ResumenEl acetaminofén es uno de los analgésicos de más amplio uso en el mundo. Su buen perfil de seguridad, eficacia y el hecho de ser de un medicamento de venta libre, hacen que la formulación y la utilización de este fármaco sea muy común, tanto en la población adulta como en la pediátrica. Los cuadros de intoxicación por acetaminofén son causa frecuente de consulta en los servicios de urgencias; por tal razón, los médicos de estas áreas deben tener un claro conocimiento sobre la fisiopatología, cuadro clínico, diagnóstico y tratamiento. En el presente artículo se hace una revisión sobre el diagnóstico y el tratamiento de los pacientes intoxicados con este medicamento.Palabras clave: acetaminofén, toxicidad, hígado, fallo hepático ACETAMINOPHEN POISONING AbstractAcetaminophen is one of the most widely used analgesics in the world. Its good safety profile, efficacy and the fact that it is on the shelf medicine, makes the formulation of this drug very common in both adult and children. Acetaminophen poisoning is a frequent motive of consultation in the emergency department, so that doctors in these areas must have a clear understanding of the pathophysiology, clinical presentation, diagnosis and treatment of this type of poisoning. In this article we make an update on the diagnosis and treatment of acetaminophen-poisoned patients.Key words: acetaminophen, toxicity, liver, liver failure INTOXICAÇÃO PELO ACETAMINOFEN ResumoO acetaminofeno é um dos analgésicos mais utilizados no mundo. Seu bom perfil de segurança, a eficácia eo fato de que um medicamento de venda livre, fazem que a formulação e utilização desta droga seja muito comum tanto na população adulta como a pediátrica. As manifestações de intoxicação por acetaminofen são causas freqüentes de consulta na unidade de emergência; Por esta razão, os médicos nessas áreas devem ter uma compreensão clara da fisiopatologia, aspectos clínicos, diagnóstico e tratamento. Neste artigo se faz uma revisão do diagnóstico e tratamento de pacientes intoxicados com essa droga.

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Safety and Effectiveness of Acetadote for Acetaminophen Toxicity

Cited by 29 publications

References 12 publications

I-FABP as Biomarker for the Early Diagnosis of Acute Mesenteric Ischemia and Resultant Lung Injury

I-FABP as Biomarker for the Early Diagnosis of Acute Mesenteric Ischemia and Resultant Lung Injury

N-acetylcysteine overdose after acetaminophen poisoning

Intoxicación por acetaminofén

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