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N-acetylcysteine overdose after acetaminophen poisoning
Ghafar Ali Mahmoudi1, Peyman Astaraki1, Azita Zafar Mohtashami1
1Faculty of Medicine, Department of Internal Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
International Medical Case Reports Journal
|March 14, 2015
Summary
N-acetylcysteine (NAC) overdose is rare but can cause serious harm, including hemolysis and acute renal failure. Careful preparation and administration are crucial to prevent accidental NAC toxicity.
Area of Science:
- Toxicology
- Pharmacology
- Emergency Medicine
Background:
- N-acetylcysteine (NAC) is a critical antidote for acetaminophen poisoning.
- It is administered in oral and intravenous forms.
Observation:
- A rare case of iatrogenic NAC overdose occurred due to preparation error.
- The patient presented with weakness, lethargy, fatigue, nausea, and dizziness.
Findings:
- Excessive NAC dosage can induce hemolysis, thrombocytopenia, and acute renal failure.
- These effects can occur even in patients with normal glucose-6-phosphate dehydrogenase levels.
- Severe NAC overdose can be fatal.
Implications:
- Clinical symptoms of NAC overdose can mimic acetaminophen poisoning.
- Meticulous attention to NAC solution preparation and patient monitoring is essential.
- Ensuring correct NAC dosage and administration prevents iatrogenic toxicity.
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