2008•New England Journal of MedicineOpen access

Acetylcysteine for Acetaminophen Poisoning

Kennon Heard

Abstract

A 25-year-old man presents to the emergency department with a toothache and is found to have been ingesting large quantities of acetaminophen. Although no acetaminophen is detectable in his blood, his serum alanine aminotransferase concentration is 750 IU per liter, and treatment with acetylcysteine is recommended. Acetylcysteine repletes glutathione stores in the liver. It helps to prevent hepatotoxicity in cases of acetaminophen overdose and also improves survival in patients with acetaminophen-induced hepatic failure.

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Key concepts: Acetaminophen, Acetylcysteine, acetaminophen overdose, Medicine, Emergency department, Alanine aminotransferase, Liver failure, Glutathione