Bonfiglio M F, Traeger S M, Hulisz D T, Martin B R
Ohio Northern University, Ada.
Ann Pharmacother. 1992 Jan;26(1):22-5. doi: 10.1177/106002809202600105.
To review the potential for anaphylactoid reactions to intravenously administered acetylcysteine when used in the treatment of acetaminophen overdose. This case is unique in that electrocardiographic changes, including ST segment depression and T-wave inversion were associated with the episode and complicated the diagnosis.
Reference articles and letters are identified in the text.
Intravenous administration of acetylcysteine has been used in the treatment of acetaminophen overdose. This route may be considered in some clinical situations where oral therapy is complicated. Anaphylactoid reactions, including cutaneous eruptions, flushing, chest pain, tachycardia, and fever have been reported in up to three percent of patients receiving intravenous acetylcysteine. The nature of these reactions and evidence concerning their etiology suggest a histamine-release phenomenon. Response to intervention with antihistamines and the safety of further acetylcysteine administration are discussed.
This case illustrates a variant anaphylactoid reaction to intravenously administered acetylcysteine and emphasizes the need for practitioners to consider the potential for these reactions prior to initiation of therapy and indicates appropriate treatment of these reactions.
回顾静脉注射乙酰半胱氨酸用于对乙酰氨基酚过量治疗时发生类过敏反应的可能性。该病例的独特之处在于，其发作伴有心电图改变，包括ST段压低和T波倒置，这使得诊断变得复杂。
文中列出了参考文献和信函。
静脉注射乙酰半胱氨酸已用于对乙酰氨基酚过量的治疗。在一些口服治疗复杂的临床情况下可考虑采用此途径。据报道，接受静脉注射乙酰半胱氨酸的患者中，高达3%出现了类过敏反应，包括皮疹、潮红、胸痛、心动过速和发热。这些反应的性质及有关其病因的证据提示这是一种组胺释放现象。讨论了抗组胺药干预的反应以及进一步给予乙酰半胱氨酸的安全性。
该病例说明了静脉注射乙酰半胱氨酸的一种变异型类过敏反应，并强调从业者在开始治疗前需要考虑这些反应的可能性，并指出了对这些反应的适当治疗方法。
