Department of Clinical Toxicology and Forensic medicine, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran. omehrpour@ razi.tums.ac.ir
Hum Exp Toxicol. 2011 Jan;30(1):51-4. doi: 10.1177/0960327110366182. Epub 2010 Mar 23.
Acetaminophen is a commonly used analgesic and has been shown to be a main cause of drug-induced liver failure. N-acetylcysteine (NAC) should be employed as the antidote in case of acetaminophen poisoning within the first 8-10 hours. Oral administration of NAC is universally recommended and due to the adverse effects, the intravenous administration of the agent is reserved for patients with oral intolerance and severe complications. We here report an 18-year-old man with severe liver failure due to a huge ingestion of acetaminophen, who was taken into the Loghman Hakim Hospital Poison Center 72 hours after attempted suicide. Regarding the poor prognostic clues as his level of consciousness and impaired liver functions, an extensive intravenous regimen of NAC was started. The patient survived the condition with an additional intravenous administration of NAC past the first 72 hours of treatment. We discuss that even in late phases of intoxication; high-dose intravenous NAC can serve a substantial improvement.
对乙酰氨基酚是一种常用的镇痛药，已被证明是导致药物性肝衰竭的主要原因。如果在 8-10 小时内发生对乙酰氨基酚中毒，应使用 N-乙酰半胱氨酸（NAC）作为解毒剂。口服 NAC 被普遍推荐，由于不良反应，该药物的静脉给药仅保留给口服不耐受和严重并发症的患者。我们在此报告了一例 18 岁男性，因大剂量摄入对乙酰氨基酚导致严重肝衰竭，在试图自杀后 72 小时被送入 Loghman Hakim 医院中毒中心。鉴于患者意识水平和肝功能受损等预后不良线索，开始给予广泛的静脉内 NAC 治疗方案。尽管患者在治疗的 72 小时后接受了额外的静脉内 NAC 给药，但仍存活下来。我们讨论了即使在中毒晚期，高剂量静脉内 NAC 也可以显著改善病情。
