The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Risk factors in the development of adverse reactions to N‐acetylcysteine in patients with paracetamol poisoning
Open accessAbstract
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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“Further, various studies have shown that patients with lower paracetamol levels have a greater rate of experiencing adverse effects when treated with NAC [77,80].”
From Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease (2023) · cites this paper as [80]
In the citing paper
“Denmark even forgoes the use of this nomogram and treats all patients with a full course of NAC regardless of paracetamol concentrations [80].”
From Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease (2023) · cites this paper as [80]
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Cites
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Berk, M., Copolov, D., Dean, O., Lu, K., Jeavons, S., Schapkaitz, I., Anderson-Hunt, M., Judd, F., Katz, F., Katz, P., et al. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.03.004 · Cited by 552
A Review of Acetaminophen Poisoning
Hodgman, M. J., & Garrard, A. R. (2012) · Critical Care Clinics · doi:10.1016/j.ccc.2012.07.006 · Cited by 314
Haber, C. A., Lam, T. K. T., Yu, Z., Gupta, N., Goh, T. T., Bogdanovic, E., Giacca, A., & Fantus, I. G. (2003) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00355.2002 · Cited by 226
Chidiac, A. S., Buckley, N. A., Noghrehchi, F., & Cairns, R. (2023) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2023.2223959 · Cited by 215
Adverse reactions associated with acetylcysteine
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Metadata
- Authors
- Schmidt, L. E., & Dalhoff, K.
- Affiliations
- Rigshospitalet (DK)
- Corresponding author
- Schmidt, L. E.
- ORCID
- Dalhoff, K
- 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
- PMC
- PMC2014432
- 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
- bronze
- doi.org
- 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
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › 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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