Adverse reactions to
            <i>N</i>
            ‐acetylcysteine during treatment for paracetamol poisoning

Dawson, Andrew; Henry, David; McEwen, John

doi:10.5694/j.1326-5377.1989.tb136496.x

Cited by 106 publications

(40 citation statements)

References 8 publications

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“…Acetylcysteine is rapidly absorbed from the gastrointestinal tract, with maximal plasma concentrations achieved within half an hour of administration of a therapeutic dose 20,21. The mechanism via which acetylcysteine works in acetaminophen poisoning is not clear.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

N-acetylcysteine overdose after acetaminophen poisoning

Mahmoudi¹,

Astaraki²,

Mohtashami³

et al. 2015

IMCRJ

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“…The number of citations for the top 100 cited articles in paracetamol poisoning treatment ranged from 44 to 553 (Mitchell et al 1974; Gazzard et al 1975; Prescott et al 1976, 1977, 1979, 1989; Rumack and Peterson 1978; Prescott 1981, 1983; Rumack et al 1981; Forrest et al 1982; Prescott and Critchley 1983; Black 1984; Mant et al 1984; Rumack 1984, 1986; Seeff et al 1986; Slattery et al 1987; Lauterburg and Velez 1988; Smilkstein et al 1988; Ziment 1988; Burgunder et al 1989; Dawson et al 1989; Riggs et al 1989; Harrison et al 1990; Murphy et al 1990; Underhill et al 1990; Flanagan and Meredith 1991; Harrison et al 1991; Holdiness 1991; Keays et al 1991; O’Grady et al 1991; Penna and Buchanan 1991; Smilkstein et al 1991; Bray et al 1992; Jones and Vale 1993; Thomas 1993; Mutimer et al 1994; Makin et al 1995; Eguia and Materson 1997; Makin and Williams 1997; Bernal et al 1998; Jones 1998; Kelly 1998; Mitchell et al 1998; Perry and Shannon 1998; Anderson et al 1999; Buckley et al 1999a, b; Detry et al 1999; McClain et al 1999; Prescott 2000; Prince et al 2000; Whyte et al 2000; Woo et al 2000; Ferner et al 2001; Schmidt and Dalhoff 2001; Ward et al 2001; Appelboam et al 2002; Gyamlani and Parikh 2002; Rumack 2002; Schiodt et al 2002; Schmidt et al 2002; Wallace et al 2002; James et al 2003; Kao et al 2003; Kozer et al 2003; Daly et al 2004; Lee 2004; Lynch and Robertson 2004; Benson et al …”

Section: Resultsmentioning

confidence: 99%

The 100 most influential publications in paracetamol poisoning treatment: a bibliometric analysis of human studies

et al. 2016

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BackgroundAnalysis of the most influential publications within paracetamol poisoning treatment can be helpful in recognizing main and novel treatment issues within the field of toxicology. The current study was performed to recognize and describe the most highly cited articles related to paracetamol poisoning treatment.MethodsThe 100 most highly cited articles in paracetamol poisoning treatment were identified from the Scopus database in November 2015. All eligible articles were read for basic information, including total number of citations, average citations per year, authors’ names, journal name, impact factors, document types and countries of authors of publications.ResultsThe median number of citations was 75 (interquartile range 56–137). These publications were published between 1974 and 2013. The average number of years since publication was 17.6 years, and 45 of the publications were from the 2000s. A significant, modest positive correlation was found between years since publication and the number of citations among the top 100 cited articles (r = 0.316; p = 0.001). A total of 55 journals published these 100 most cited articles. Nine documents were published in Clinical Toxicology, whereas eight documents were published in Annals of Emergency Medicine. Citations per year since publication for the top 100 most-cited articles ranged from 1.5 to 42.6 and had a mean of 8.5 citations per year and a median of 5.9 with an interquartile range of 3.75–10.35. In relation to the origin of the research publications, they were from 8 countries. The USA had the largest number of articles, 47, followed by the UK and Australia with 38 and nine articles respectively.ConclusionsThis study is the first bibliometric assessment of the top 100 cited articles in toxicology literature. Interest in paracetamol poisoning as a serious clinical problem continues to grow. Research published in high-impact journals and from high income countries is most likely to be cited in published paracetamol research.

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“…So that the flowchart can be used as a stand alone tool to guide patient management we have included the standard UK plasma paracetamol treatment nomogram, 8 12 37 together with information boxes on risk factors for paracetamol poisoning, [13][14][15][16][17][18][19] doses of N-acetylcysteine 8 40 and management of adverse reactions to N-acetylcysteine. 41 29 30 Wait until 4 hours postingestion 8 23 Is the patient at risk? See risk box Dose taken?…”

Section: Methodsmentioning

confidence: 99%

“…50 mg/kg in 7 ml/kg 5% dextrose over 4 hours followed by 3. 100 mg/kg in 14 ml/kg 5% dextrose over 16 hours Adverse reactions to N-acetylcysteine (NAC) 41 42 NAC can cause adverse effects which include flushing, itching, rashes, angioedema, bronchospasm, and hypertension. NAC should be stopped and, if necessary, an intravenous antihistamine given.…”

Section: Yesmentioning

confidence: 99%

Paracetamol overdose: an evidence based flowchart to guide management

Wallace

2002

Emergency Medicine Journal

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Adverse reactions to N ‐acetylcysteine during treatment for paracetamol poisoning

Cited by 106 publications

References 8 publications

N-acetylcysteine overdose after acetaminophen poisoning

N-acetylcysteine overdose after acetaminophen poisoning

The 100 most influential publications in paracetamol poisoning treatment: a bibliometric analysis of human studies

Paracetamol overdose: an evidence based flowchart to guide management

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