N-acetylcysteine overdose after acetaminophen poisoning

International Medical Case Reports Journal
Ghafar Ali MahmoudiMaryam Ahadi

Abstract

N-acetylcysteine (NAC) is used widely and effectively in oral and intravenous forms as a specific antidote for acetaminophen poisoning. Here we report a rare case of iatrogenic NAC overdose following an error in preparation of the solution, and describe its clinical symptoms. Laboratory results and are presented and examined. A 23-year-old alert female patient weighing 65 kg presented to the emergency ward with weakness, lethargy, extreme fatigue, nausea, and dizziness. She had normal arterial blood gas and vital signs. An excessive dosage of NAC over a short period of time can lead to hemolysis, thrombocytopenia, and acute renal failure in patients with normal glucose-6-phosphate dehydrogenase, and finally to death. Considering the similarity between some of the clinical symptoms of acetaminophen overdose and NAC overdose, it is vitally important for the administration phases and checking of the patient's symptoms to be carried out attentively and cautiously.

Citations

Aug 8, 2015·Drug Development Research·Solomon E OwumiLeonore A Herzenberg
Aug 26, 2016·British Journal of Clinical Pharmacology·George P BaileyPaul I Dargan
May 20, 2018·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Gamal A SalemRavi P Sahu
Mar 3, 2021·Environmental Science and Pollution Research International·Lola Virág KissPéter István Nagy
Jul 3, 2021·Antioxidants·Micaely Cristina Dos Santos TenórioMarília Oliveira Fonseca Goulart

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