The most common reactions to intravenous acetylcysteine are nausea, vomiting and cutaneous systemic hypersensitivity reactions. These include rash, nausea and vomiting, angioedema, flushing, tachycardia, bronchospasm, hypotension and death. The traditional three bag protocol is associated with a high rate of adverse reactions, ranging from mild to severe.
It is almost completely protective against deaths secondary to paracetamol-induced liver injury when administered within 8 hours of ingestion. Traditionally acetylcysteine is given over a series of three infusions given over 20 hours. Acetylcysteine also supplies thiol groups, which can directly bind with NAPQI in hepatocytes and enhances non-toxic sulfate conjugation. Acetylcysteine is a cysteine precursor, it is hydrolysed intracellularly to cysteine, which replenishes glutathione. Glutathione is essential in the metabolism of NAPQI (toxic paracetamol metabolite. Its efficacy as a specific antidote for paracetamol poisoning relies mainly on its ability to stimulate glutathione synthesis.
For additional information visit Linking to and Using Content from MedlinePlus.Guest Post – Dr Angela Chiew – Australian Clinical Toxicologist and Emergency Staff SpecialistĪcetylcysteine is the most widely used antidote for paracetamol poisoning. Any duplication or distribution of the information contained herein is strictly prohibited without authorization. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. This site complies with the HONcode standard for trustworthy health information: verify here. Learn more about A.D.A.M.'s editorial policy editorial process and privacy policy. is among the first to achieve this important distinction for online health information and services. follows rigorous standards of quality and accountability. is accredited by URAC, for Health Content Provider (URAC's accreditation program is an independent audit to verify that A.D.A.M.
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