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Intravenous administration of oral N-acetylcysteine
1Rocky Mountain Poison and Drug Center and Denver Health Medical Center, Department of Surgery, University of Colorado Health Science Center 80220, USA.
Objective:
To report the indications and adverse events associated with administration of the oral N-acetylcysteine preparation by the intravenous route.
Design:
Retrospective consecutive case series analysis of 226,720 Toxic Exposure Surveillance System data sheets from a certified regional poison center during the period January 1, 1992 through December 31, 1993.
Setting:
A regional poison center certified by the American Association of Poison Control Centers.
Patients:
Seventy-six patients treated with the oral N-acetylcysteine solution by the intravenous route.
Interventions:
None.
Measurements And Main Results:
We report the indications and adverse events associated with the intravenous administration of the oral N-acetylcysteine preparation. Four (4/76, 5.3%) patients developed adverse events attributable to N-acetylcysteine. None of these events involved hemodynamic, cardiovascular, or pulmonary effects. All reactions occurred during infusion of the initial N-acetylcysteine dose. There were three (3/76, 3.9%) deaths overall; however, they were not attributable to the intravenous administration of the oral N-acetylcysteine preparation.
Conclusions:
Intravenous administration of the oral N-acetylcysteine preparation appears to have limited adverse effects and offers another mechanism of delivery of the potentially lifesaving N-acetylcysteine when oral administration is not possible.