Tylenol OD antidote has 8-hour window.

Harris, director of
the toxicology section at Regions Hospital, St. The hepatotoxicity risk is increased in alcoholics,
patients on hepatic enzyme inducing medications, and in those older than
age 45 years.

A serum acetaminophen level of 150 mcg/mL at 4 hours post ingestion warrants NAC therapy. Carson R. Food and Drug Administration in both
oral (Mucomyst) and intravenous (Acetadote) forms for the treatment of
acute overdoses.

The advantages of Acetadote are that it's well tolerated and
can be given in a 20- or 48-hour protocol, whereas oral NAC smells like
rotten eggs and is approved as a 72-hour treatment regimen.

However, Dr. That's what we do. Harris continued.

Oral NAC comes in a 20% solution that should be diluted to 5% in
juice or soda. You may have
to continue treatment for another 20 hours or so," he explained.

The wholesale cost of enough generic NAC for 24 hours of oral
therapy in a 70-kg patient is S18, compared with $430 for Acetadote.

BY BRUCE JANCIN

Denver Bureau

COPYRIGHT 2007 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2007 Gale, Cengage Learning. DALLAS -- N-acetylcysteine for acetaminophen overdose is one of thebest antidotes in all of poison control medicine--provided it'sgiven within the right time frame, Dr. It is a free-radical scavenger that binds and
neutralizes acetaminophen's toxic metabolite, increases glutathione
synthesis, and improves hepatic microcirculation.

NAC is approved by the U.S. We almost never have
patients who take a Tylenol overdose stay in the hospital for 72 hours
if they get NAC within 8 hours," Dr. That's your key, that 8-hour window. Harris stressed that there's nothing magic about the 20-,
24-, 48-, or 72-hour treatment http://zofranrecallcenter.com/zofran-manufacturer/ - zofran lawsuit commercial - cutoffs.

"If your patient still feels sick and the liver enzymes are
going up, it usually means you got treatment started late. Harris said at theannual meeting of the Society of Hospital Medicine."This is a great antidote. The sulfur odor is a real problem; antiemetic therapy
with metoclopramide (Reglan) or ondansetron (Zofran) is http://cancer.emedtv.com/zofran/zofran-side-effects.html - http://cancer.emedtv.com/zofran/zofran-side-effects.html - often necessary.

Dr. NAC protects the liver and reduces the risk of
cerebral edema. Harris and other poison control experts use an
abbreviated oral NAC schedule that gets most patients out of the
hospital in 24 hours. All rights reserved.. A
patient can take 3 pounds of acetaminophen--I've had one who
tried--and if you start NAC [N-acetylcysteine] within 8 hours
they'll still probably be okay," said Dr. It entails a 140-mg/kg loading dose followed by 70
mg/kg maintenance doses given every 4 hours.

"If the patient is not pregnant and doesn't have any
other factors that may cause increased toxicity, you can actually stop
treatment after 24 hours if at that point the acetaminophen level is
less than 2 mg/L and transaminases are less than two to three times the
upper limit of normal. It's virtually 100% effective
if given within 8 hours. Paul, Minn.

Acetaminophen is one of the most common causes of overdose.
That's because acetaminophen is present in more than 200
over-the-counter and prescription drug products, including a plethora of
cold and allergy medications.

"We get an acetaminophen level on every altered-mental-status
patient who comes in," he said.

Liver damage can occur in adults who take 150 mg/kg of
acetaminophen