8/8/2023 0 Comments Muconyst antidote for tylenol![]() ![]() Acetylcysteine for acetaminophen poisoning. Adverse reactions associated with acetylcysteine. Intravenous administration of Nacetylcysteine: interference with coagulopathy testing. Improved outcome of paracetamol-induced fulminant hepatic failure by late administration of N-acetylcysteine. ↑ Harrison PM, Keays R, Bray GP, et al.(Prospective randomized controlled trial 50 patients) Intravenous acetylcysteine in paracetamol-induced fulminant hepatic failure: a prospective controlled trial. ↑ Keays R, Harrison PM, Wendon JA, et al.Intravenous acetylcysteine is indicated for the treatment of acetaminophen overdose by preventing depletion of glutathione reserves.Total acetylcysteine: Adults: 5.6 hours, Newborns: 11 hours.Consider mixing with juice or soda, in a cup with a lid and straw sulfur-smell causes nausea and vomiting.Epinephrine is not recommended although it can be used in patients with severe progressive symptoms.Restart NAC infusion at a slower rate 1 hour after administration of medical therapy.If angioedema, bronchospasm, or hypotension, then Diphenhydramine, corticosteroids, and bronchodilators along with cessation of the NAC.No treatment is necessary for isolated flushing.Anaphylaxis responds to standard therapies and can usually restart NAC safely without complications.Anaphylactoid reaction but also associated with seizures, cerebral edema, & herniation.IV formulation may be preferred to increase fetal NAC concentrations.Both IV or oral NAC may be used in pregnant patients with Acetaminophen toxicity.Third Dose: 10,000 mg in 1,000 mL diluent, infused over 16 hours.Second Dose: 5,000 mg in 500 mL diluent, infused over 4 hours. ![]() Loading Dose: 15,000 mg in 200 mL diluent, infused over 1 hour.Third Dose: 100 mg/kg in 500 mL diluent, infused over 16 hours.Second Dose: 50 mg/kg in 250 mL diluent, infused over 4 hours.Loading Dose: 150 mg/kg in 100 mL diluent, infused over 1 hour.Third Dose: 100 mg/kg in 14 mL/kg diluent, infused over 16 hours.Second Dose: 50 mg/kg in 7 mL/kg diluent, infused over 4 hours.Loading Dose: 150 mg/kg in 3 mL/kg diluent, infused over 1 hour.Add 3 mL of diluent to each 1 mL (200 mg) of 20% acetylcysteine solutionįor pediatrics (0-18) the addition of a dilution of NAC should be followed to avoid electrolyte and fluid problems. ![]() Maintenance Dose: 2 g (10 mL) in 30 mL diluent total volume: 40 mL.Loading dose: 4 g (20 mL) in 60 mL diluent total volume: 80 mL.Maintenance Dose: 3 g (15 mL) in 45 mL diluent total volume: 60 mL.Loading dose: 6 g (30 mL) in 90 mL diluent total volume: 120 mL.Maintenance Dose: 3.5 g (18 mL) in 52 mL diluent total volume: 70 mL.Loading dose: 7 g (35 mL) in 105 mL diluent total volume: 140 mL.Maintenance Dose: 4 g (20 mL) in 60 mL diluent total volume: 80 mL.Loading dose: 8 g (40 mL) in 120 mL diluent total volume: 160 mL.Maintenance Dose: 5 g (25 mL) in 75 mL diluent total volume: 100 mL.Loading dose: 10 g (50 mL) in 150 mL diluent total volume: 200 mL.Maintenance Dose: 5.5 g (28 mL) in 82 mL diluent total volume: 110 mL.Loading dose: 11 g (55 mL) in 165 mL in diluent total volume: 220 mL.Maintenance Dose: 6.5 g (33 mL) in 97 mL diluent total volume: 130 mL.Loading dose: 13 g (65 mL) in 195 mL diluent total volume: 260 mL.Maintenance Dose: 7 g (35 mL) in 105 mL diluent total volume: 140 mL.Loading dose: 14 g (70 mL) in 210 mL diluent total volume: 280 mL.Maintenance Dose: 7.5 g (37 mL) in 113 mL diluent total volume: 150 mL.Loading dose: 15 g (75 mL) in 225 mL diluent total volume: 300 mL.Maintenance Dose: 70 mg/kg body weight, orally, 4 hours after the loading dose and every 4 hours for 17 total doses, unless repeated acetaminophen assays reveal nontoxic levels.140 mg/kg body weight, orally, once as a loading dose.įor children there is a diluent added to the NAC so that there is no electrolyte and volume complications. May see a dose-dependent increase in PT following NAC in patients without hepatotoxicity. ![]() Give NAC until LFTs improve (not until APAP level is 0)
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