Management of Anaphylactoid Reactions to Intravenous N-Acetylcysteine

Bailey, Benoît; McGuigan, Michael A.

doi:10.1016/s0196-0644(98)70229-x

Cited by 126 publications

(72 citation statements)

References 23 publications

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“…As an extensively used and relatively safe drug (6), NAC may be a useful adjuvant for the protection of the myocardium in cardiac surgery, for example as an additive to the cardioplegic solutions. Therefore, given the role of the vascular endothelium in the control of vascular function and its ability to attenuate ischemia-reperfusion-related injuries to the myocardium (7), the present study was carried out in order to determine the effects of oxidative stress on the vascular reactivity of canine coronary arteries, as well as the protective role of NAC in an in vitro model of oxidative stress (8).…”

Section: Introductionmentioning

confidence: 99%

Protective effect of N-acetylcysteine against oxygen radical-mediated coronary artery injury

Rodrigues

Évora

Schaff

2004

Braz J Med Biol Res

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The present study investigated the protective effect of N-acetylcysteine (NAC) against oxygen radical-mediated coronary artery injury. Vascular contraction and relaxation were determined in canine coronary arteries immersed in Kreb's solution (95% O 2 -5% CO 2 ), incubated or not with NAC (10 mM), and exposed to free radicals (FR) generated by xanthine oxidase (100 mU/ml) plus xanthine (0.1 mM). Rings not exposed to FR or NAC were used as controls. The arteries were contracted with 2.5 µM prostaglandin F2α. Subsequently, concentration-response curves for acetylcholine, calcium ionophore and sodium fluoride were obtained in the presence of 20 µM indomethacin. Concentration-response curves for bradykinin, calcium ionophore, sodium nitroprusside, and pinacidil were obtained in the presence of indomethacin plus N ω -nitro-L-arginine (0.2 mM). The oxidative stress reduced the vascular contraction of arteries not exposed to NAC (3.93 ± 3.42 g), compared to control (8.56 ± 3.16 g) and to NAC group (9.07 ± 4.0 g). Additionally, in arteries not exposed to NAC the endothelium-dependent nitric oxide (NO)-dependent relaxation promoted by acetylcholine (1 nM to 10 µM) was also reduced (maximal relaxation of 52.1 ± 43.2%), compared to control (100%) and NAC group (97.0 ± 4.3%), as well as the NO/cyclooxygenase-independent receptor-dependent relaxation provoked by bradykinin (1 nM to 10 µM; maximal relaxation of 20.0 ± 21.2%), compared to control (100%) and NAC group (70.8 ± 20.0%). The endothelium-independent relaxation elicited by sodium nitroprusside (1 nM to 1 µM) and pinacidil (1 nM to 10 µM) was not affected. In conclusion, the vascular dysfunction caused by the oxidative stress, expressed as reduction of the endothelium-dependent relaxation and of the vascular smooth muscle contraction, was prevented by NAC.

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Section: Introductionmentioning

confidence: 99%

Protective effect of N-acetylcysteine against oxygen radical-mediated coronary artery injury

Rodrigues

Évora

Schaff

2004

Braz J Med Biol Res

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“…Potentially, this reaction could be anticipated and preempted, or addressed quickly with the administration of an antihistamine, steroids, or epinephrine as needed, an approach advocated previously for the management of anaphylactoid reactions to intravenous NAC. 10 The results presented in this study are encouraging; however, they raise further question as to whether intravenous NAC is beneficial in pediatric patients with non-APAP-induced ALF. It is possible that some of the patients diagnosed as non-APAP-induced ALF may in fact have been APAP-adduct positive, suggesting "subtoxic" exposure to APAP, which would significantly impact disease progression.…”

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confidence: 63%

Is there a “NAC” to treating acute liver failure in children?

Leonis

Balistreri

2007

Liver Transpl

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“…Hafif yan etkilerde infüzyonun durdurulması ve antihistaminik verilmesi ile semptomlar düzelmektedir. 6,7,12 Olgumuzda da NAC infüzyonunun durdurulması ve intramuskü-ler adrenalin verilmesinden kısa bir süre sonra anafilaksi semptomları gerilemiştir.…”

Section: Olgu Sunumuunclassified