This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (58)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Laurie F. Prescott, MD, FRCPEdin

Arch Intern Med. 1981;141(3):386-389.

Abstract
• Intravenous (IV) acetylcysteine, cysteamine, and methionine treatments were compared in patients with severe acetaminophen poisoning; a control group consisted of patients receiving supportive therapy only. Acetylcysteine proved the safest and most effective mode of treatment. Acetylcysteine was effective in preventing liver damage, hepatic failure, renal damage, and death when given eight to ten hours after poisoning. When treatment was delayed for ten to 24 hours, results were the same as in the supportive-therapy group. The alanine aminotransferase (ALT) activity remained normal in 76% of the patients treated within ten hours, as compared with 40% in both cysteamine- and methionine-treated groups and with 16% in the supportive-therapy group. The ingestion-treatment interval for complete protection with all three drugs was eight hours; beyond that time, the incidence of damage increased steadily. After 15 hours, all treatments were pointless. Based on my experience, IV administration is preferable, since nausea and vomiting may limit the effectiveness of oral therapy.

(Arch Intern Med 1981;141:386-389)

Author Affiliations
From the Regional Poisoning Treatment Centre and the University Department of Therapeutics and Clinical Pharmacology, The Royal Infirmary, Edinburgh.

Footnotes
Reprint requests to Department of Therapeutics, The Royal Infirmary, Edinburgh, Scotland (Dr Prescott).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Oral methionine compared with intravenous n-acetyl cysteine for paracetamol overdose
Alsalim and Fadel
Emerg. Med. J. 2003;20:366-367.
ABSTRACT | FULL TEXT  

Treatment strategies for early presenting acetaminophen overdose: a survey of medical directors of poison centers in North America and Europe
Kozer and McGuigan
Hum Exp Toxicol 2002;21:123-127.
ABSTRACT  

Neonatal paracetamol poisoning
AW et al.
Arch. Dis. Child. Fetal Neonatal Ed. 1999;81:77F-77.
FULL TEXT  

The Mechanism of Paracetamol-induced Hepatotoxicity: Implications for Therapy
Huggett and Blair
Hum Exp Toxicol 1983;2:399-405.
ABSTRACT