Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Fewer adverse effects associated with a modified two-bag intravenous acetylcysteine protocol compared to traditional three-bag regimen in paracetamol overdose

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Adverse effects associated with high-dose olanzapine therapy in patients admitted to inpatient psychiatric care

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The role of the glutathione S-transferase genes GSTT1, GSTM1, and GSTP1 in acetaminophen-poisoned patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Successful reversal of life threatening cardiac effect following dosulepin overdose using intravenous lipid emulsion

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Assisted reproductive technology treatment and risk of ovarian cancer-a nationwide population-based cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Pharmacokinetics of Ferric bepectate - a new intravenous iron drug for treating iron deficiency

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Transcription profile of the insulin-like growth factor signaling pathway during human ovarian follicular development

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Ventrikelaspiration er meget sjældent indiceret ved forgiftninger

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

CONTEXT: The intravenous (IV) N-acetylcysteine (NAC) regimen used worldwide in paracetamol overdose is complex with three separate weight-based doses and is associated with a high incidence of adverse events including non-allergic anaphylactoid reactions (NAARs). In 2012, Denmark adopted the two-bag IV NAC regimen which combined the first two infusions of the three-bag regimen and kept the third infusion unchanged. We compared the safety and efficacy of the two-bag IV NAC regimen with the traditional Danish three-bag regimen.

METHODS: A medical chart review was conducted in three Danish medical centers from January 2012 through December 2014. Safety and efficacy data were compared for patients who received the traditional infusion protocol in Denmark or the 20-h two-bag IV regimen.

RESULTS: Four hundred and ninety-three cases received the two-bag regimen and 274 received the three-bag regimen. The overall incidence of NAARs was 9% with all being mild to moderate in intensity. Fewer subjects in the two-bag group (4%) developed NAARs compared to 17% in the three-bag group (p < .001). Overall, 31 patients (4%) developed hepatotoxicity. There was no apparent difference in hepatotoxicity rates between the groups and no deaths or liver transplants. Patients receiving the two-bag regimen had fewer interruptions or delays (5%) compared to the three-bag regimen cohort (12%). Overall, there were very few medication errors reported (1%).

CONCLUSIONS: The incidence of NAARs was lower in patients receiving acetylcysteine in a two-bag regimen compared to the traditional Danish three-bag regimen without an apparent reduction in efficacy.

OriginalsprogEngelsk
TidsskriftClinical toxicology (Philadelphia, Pa.)
Vol/bind56
Udgave nummer11
Sider (fra-til)1128-34
ISSN1556-3650
DOI
StatusUdgivet - 2018

ID: 56502845