Use of Intravenous N-Acetyl Cysteine in Paracetamol Intoxication

Abstract

Objective: In this study, we aimed to present our clinical experiences of intravenous (IV) N-Acetyl cystein administration in patients admitted to our emergency department with paracetamol intoxication. Material and Methods: This study was conducted between January 2007 and December 2009, in the Ondokuz Mayis University Medical Faculty Hospital, Emergency Service, and the hospital records of adult patients admitted with paracetamol poisoning were examined retrospectively. Fifty three patients who were exposed to toxic dose and administered IV NAC therapy were included in the study. In acute intoxication 140mg/kg and 7.5 gr and above in 24 hours were considered as toxic dose. Obtained data using SPSS 15.0 (Statistical Package for Social Science) program was recorded and analyzed. Data are given as mean +/- standard deviation. Results: Of the patients, 27 were female (50.9%) average age 25.0 +/- 7.1 years, and 26 were male (49.1%) average age 29.5 +/- 10.4 years. There was no difference in the average age of the sexes (p > 0.05). Nausea and/or vomitting was determined in 56.6% of the patients. Average dose ingested was 11.9 +/- 4.5. In 64.2% of the patients, we determined a co-ingestion of other drugs. Average time of therapy initiation was 5.8 +/- 4.9 hours. Complication due to IV NAC therapy (urticarial reaction) was observed in one patient (1.9%). This complication improved with antihistaminic therapy. Conclusion: A few complications -most of them were minor-due to IV NAC therapy used in paracetamol intoxication were observed. Even if IV NAC therapy seems to be safe in paracetamol intoxication, wide prospective studies are needed for confirmation.