Articles: acetaminophen.
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J. Toxicol. Clin. Toxicol. · Jan 1998
Comparative StudyUse of ondansetron and other antiemetics in the management of toxic acetaminophen ingestions.
Patients presenting with acetaminophen toxicity and vomiting are often treated with antiemetics so that orally administered N-acetylcysteine can be retained. The policy at the West Virginia Poison Center is to reserve ondansetron, an antiemetic with a higher cost than other antiemetics, as a second line agent for patients presenting within 8 hours of an acetaminophen ingestion. ⋯ Ondansetron should be utilized as a second-line agent in the management of acetaminophen toxic patients with vomiting. Because of its lower failure rate, ondansetron should be administered as a first-line agent in patients with a delay in N-acetylcysteine administration approaching 8 or more hours.
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Practice Guideline Guideline
The impact of nationally distributed guidelines on the management of paracetamol poisoning in accident and emergency departments. National Poison Information Service.
To assess the impact of the treatment guidelines on the management of paracetamol self poisoning in accident and emergency (A&E) departments. ⋯ Regularly updated guidelines in the management of paracetamol poisoning should be displayed in A&E departments so that medical and nursing personnel have access to the best current information on the treatment of poisoning with this frequently used drug.
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The Journal of pediatrics · Jan 1998
Comparative Study Clinical TrialEfficacy of oral versus intravenous N-acetylcysteine in acetaminophen overdose: results of an open-label, clinical trial.
We compared the clinical course of pediatric patients (n = 25) with acetaminophen poisoning treated with an investigational intravenous preparation of N-acetylcysteine (IV-NAC) with that of historical control subjects (n = 29) treated with conventional oral NAC (O-NAC) therapy. Patients received IV-NAC for 52 hours; historical control subjects received O-NAC (72 hours). There were no significant intergroup differences between treatment groups in age (15.5 vs 15.9 years), gender (88% vs 90% female) or distribution of risk categories (probable risk, 12 vs 15; high risk; 13 vs 14). ⋯ Hepatoxicity was noted in two (8.0%) patients in the IV-NAC treatment group and two (6.9%) patients in the O-NAC group. All patients recovered. Our results indicate that 52 hours of intravenous NAC is as effective as 72 hours of oral NAC.
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To report the indications and adverse events associated with administration of the oral N-acetylcysteine preparation by the intravenous route. ⋯ Intravenous administration of the oral N-acetylcysteine preparation appears to have limited adverse effects and offers another mechanism of delivery of the potentially lifesaving N-acetylcysteine when oral administration is not possible.
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Paracetamol is a common cause of fatal self-poisoning in the UK every year. Despite this, it continues to be sold freely without medical supervision and can be found in quantity in most household medicine cabinets.