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N-acetylcysteine overdose after acetaminophen poisoning

Authors Mahmoudi GA, Astaraki P, Zafar Mohtashami A, Ahadi M

Received 18 September 2014

Accepted for publication 26 November 2014

Published 27 February 2015 Volume 2015:8 Pages 65—69


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Ronald Prineas

Ghafar Ali Mahmoudi,1 Peyman Astaraki,1 Azita Zafar Mohtashami,1 Maryam Ahadi2

1Faculty of Medicine, Department of Internal Medicine, Lorestan University of Medical Sciences, 2Legal Medicine Research Center of Lorestan, Khorramabad, Iran

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.

Keywords: N-acetylcysteine, overdose, acetaminophen poisoning, medication error

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