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Interaction between N-acetylcysteine and activated charcoal: implications for the treatment of acetaminophen
P K Tenenbein1, D S Sitar, M Tenenbein
1Department of Anesthesiology, University of Manitoba, Winnipeg, Canada.
Study Objective:
To determine if the presence of N-acetylcysteine reduces the ability of activated charcoal to adsorb acetaminophen both in the absence and presence of a coingestant.
Design:
In vitro laboratory study.
Setting:
University hospital research laboratory.
Measurements And Main Results:
The adsorption of acetaminophen and salicylic acid by activated charcoal in the presence and absence of N-acetylcysteine was measured in vitro. Acetaminophen and salicylic acid analyses were conducted with high-performance liquid chromatography. Adsorption data were compared using the appropriate parametric statistical test. The addition of N-acetylcysteine significantly decreased the binding of acetaminophen by activated charcoal (p<0.005). When salicylic acid was added to simulate a coingestant, N-acetylcysteine significantly decreased salicylate adsorption by charcoal (p<0.001).
Conclusions:
The presence of N-acetylcysteine reduces the ability of activated charcoal to adsorb acetaminophen and coingestants. In vivo data will be required to determine the clinical relevance of these interactions.
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