Citation

Hodgman MJ, Garrard AR. Crit. Care Clin. 2012; 28(4): 499-516.

Affiliation

Department of Emergency Medicine, Upstate New York Poison Center, SUNY Upstate Medical University, Suite 202, 250 Harrison Street, Syracuse, NY 13202, USA; Emergency and Trauma Services, Bassett Medical Center, Cooperstown, NY 13326, USA. Electronic address: hodgmanm@upstate.edu.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.ccc.2012.07.006

PMID

22998987

Abstract

Acetaminophen poisoning remains one of the more common drugs taken in overdose with potentially fatal consequences. Early recognition and prompt treatment with N-acetylcysteine can prevent hepatic injury. With acute overdose, the Rumack-Matthew nomogram is a useful tool to assess risk and guide management. Equally common to acute overdose is the repeated use of excessive amounts of acetaminophen. Simultaneous ingestion of several different acetaminophen-containing products may result in excessive dosage. These patients also benefit from N-acetylcysteine. Standard courses of N-acetylcysteine may need to be extended in patients with persistently elevated plasma concentrations of acetaminophen or with signs of hepatic injury.

Language: en