Cited by 128Drug-Induced Hepatotoxicity and ProtectionPoisoning and overdose treatmentsParaquat toxicity studies and treatments

Risk factors in the development of adverse reactions to N‐acetylcysteine in patients with paracetamol poisoning

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Schmidt, L. E., Dalhoff, K·2001·British Journal of Clinical Pharmacology

Abstract

Aims To identify risk factors in the development of side‐effects to N‐acetylcysteine (NAC) in patients with paracetamol poisoning. Methods A retrospective study was carried out based upon the hospital charts of 529 consecutive patients admitted with paracetamol poisoning, all treated with NAC, at the Department of Hepatology, Copenhagen University Hospital (the tertiary care centre of liver disease in Denmark). Results Forty‐five patients (8.5%; 95% confidence intervals (CI) 6.4, 11%) developed side‐effects to NAC and 18 patients (3.4%; 95% CI 2.1, 5.4%) developed systemic side‐effects. Asthmatics were 2.9 times (95% CI 2.1, 4.7) more likely to develop side‐effects (Chi‐square: P = 0.004). Side‐effects were of similar severity in asthmatics and nonasthmatics. A history of medical allergy was not a risk factor. Serum paracetamol was lower in patients with side‐effects than in those without (Mann–Whitney: P = 0.00006). Conclusions Asthma must be considered a risk factor in the development of side‐effects to NAC. However, the side‐effects are easily managed and there is no reason to withhold NAC from any patient with paracetamol poisoning. Paracetamol itself seems to offer some protection against the development of side‐effects to NAC.

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Crossref · 10.1046/j.1365-2125.2001.01305.x

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Research works printed but not linked: 4

  1. Clemmesen JO, Ott P, Dalhoff KP, Astrup LB, Tage-Jensen U, Poulsen HE. Rekommandation for behandling af paracetamolforgiftning. Ugeskr Lñger 1996; 158: 6892±6895.
  2. Bridger S, Henderson K, Glucksman E, Ellis AJ, Henry JA, Williams R. Deaths from low dose paracetamol poisoning. Br Med J 1998; 316: 1724±1725.
  3. Schmidt LE, Dalhoff KP. Bivirkninger ved N-acetylcystein-behandling af paracetamolforgiftede patienter. Ugeskr Lñger 1999; 161: 2669±2672.
  4. Panush RS. Effects of certain antirheumatic drugs on normal human peripheral blood lymphocytes. Arthritis Rheumatism 1976; 19: 907±917.

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Authors
Schmidt, L. E., & Dalhoff, K.
Affiliations
Rigshospitalet (DK)
Corresponding author
Schmidt, L. E.
Venue
British Journal of Clinical Pharmacology
Publisher
Wiley
Published
2001-01
Volume
51
Issue
1
Pages
87-91
ISSN
  • 0306-5251 (ISSN-L)
  • 1365-2125
OpenAlex
W1597851562
Cited by
127
References
24
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 1 · 2019: 5 · 2018: 6 · 2017: 3 · 2016: 5 · 2015: 12 · 2014: 6 · 2013: 9 · 2012: 7
FWCI
4.87
Type
journal article
Language
en
Open access
Locations
  • British Journal of Clinical Pharmacology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
  • Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
  • Health Sciences › Medicine › Surgery › Paraquat toxicity studies and treatments
Keywords
N-acetylcysteine, acetaminophen toxicity, adverse drug reactions, asthma, risk factors, systemic side effects, drug hypersensitivity, hepatoprotection
MeSH terms
Acetaminophen, Acetylcysteine, Adolescent, Adult, Aged, Aged, 80 and over, Child, Denmark, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Poisoning, Prognosis, Risk Factors, Analgesics, Non-Narcotic, Drug Overdose

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