对乙酰氨基酚中毒时止吐药的使用：N-乙酰半胱氨酸的给药途径如何影响其使用情况？
Antiemetic use in acetaminophen poisoning: how does the route of N-acetylcysteine administration affect utilization?
作者信息
Miller Melissa A, Navarro Marisela, Bird Steven B, Donovan Jennifer L
机构信息
Department of Pharmacy, UMass Memorial Medical Center, MA, USA.
出版信息
J Med Toxicol. 2007 Dec;3(4):152-6. doi: 10.1007/BF03160931.
INTRODUCTION
We sought to compare antiemetic use after acetaminophen poisoning in patients treated with oral or intravenous (IV) N-acetylcysteine (NAC).
METHODS
Our retrospective chart review identified 20 orally treated patients and 17 IV-treated patients. For both groups, we calculated the total number of antiemetic doses given, their associated cost, and also determined parameters that correlated with antiemetic use.
RESULTS
IV-treated patients received fewer total antiemetic doses than those receiving oral NAC (1.1 0.2 vs. 2.8 0.7; P 0.04). Antiemetic cost correlated with doses received for both groups; however, because the regression lines differed (P 0.02), antiemetic therapy cost was less in IV-treated patients. In addition, serum acetaminophen concentration correlated with total antiemetic doses in oral NAC patients (P 0.002) but not with IV treatment patients (P 0.78).
CONCLUSIONS
Intravenous NAC reduced antiemetic utilization, and it costs less than oral therapy. Furthermore, antiemetic use appeared to be determined by a combination of acetaminophen concentration and NAC administration route.
引言
我们试图比较口服或静脉注射N - 乙酰半胱氨酸（NAC）治疗对乙酰氨基酚中毒患者后的止吐药使用情况。
方法
我们通过回顾性病历审查确定了20例口服治疗患者和17例静脉治疗患者。对于两组患者，我们计算了给予的止吐药总剂量、相关费用，并确定了与止吐药使用相关的参数。
结果
静脉治疗患者接受的止吐药总剂量少于口服NAC的患者（1.1±0.2对2.8±0.7；P = 0.04）。两组的止吐药费用均与所接受的剂量相关；然而，由于回归线不同（P = 0.02），静脉治疗患者的止吐治疗费用较低。此外，血清对乙酰氨基酚浓度与口服NAC患者的止吐药总剂量相关（P = 0.002），但与静脉治疗患者无关（P = 0.78）。
结论
静脉注射NAC减少了止吐药的使用，且费用低于口服治疗。此外，止吐药的使用似乎由对乙酰氨基酚浓度和NAC给药途径共同决定。
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