Acetylcysteine for acetaminophen poisoning.
Acetylcysteine for acetaminophen poisoning.
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DOI：
10.1056/nejmct0708278
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发表时间：
2008-07-17
期刊：
影响因子：
--
通讯作者：
Heard KJ
中科院分区：
文献类型：
--
作者：
Heard KJ
一名25岁的男子牙痛到急诊科就诊。在评估中，医生确定患者在过去5天里一直在服用大剂量的非处方药对乙酰氨基酚和对乙酰氨基酚氢可酮产品。他每天服用对乙酰氨基酚的剂量为12克(最大推荐剂量为每天4克)。他没有其他健康问题，通常一天喝两瓶啤酒。患者除牙痛外没有其他症状，没有黄疸，也没有肝肿大或右上腹压痛。他在最近一次服药后8小时的血清对乙酰氨基酚浓度是检测不到的。他的血清丙氨酸氨基转移酶浓度为75IU/升，血清胆红素浓度为每分升1.2毫克(20.5μ摩尔/升)，其国际标准化比值为1.1。急诊科医生联系地区毒物控制中心，该中心建议使用乙酰半胱氨酸治疗。
A 25-year-old man presents to the emergency department with a toothache. During the evaluation, the physician determines that the patient has been taking large doses of over-the-counter acetaminophen along with an acetaminophen–hydrocodone product for the past 5 days. His daily dose of acetaminophen has been 12 g per day (maximum recommended dose, 4 g per day). He has no other medical problems and typically consumes two beers a day. The patient has no symptoms beyond his toothache, is not icteric, and has no hepatomegaly or right-upper-quadrant tenderness. His serum acetaminophen concentration 8 hours after the most recent dose is undetectable. His serum alanine aminotransferase concentration is 75 IU per liter, his serum bilirubin concentration is 1.2 mg per deciliter (20.5 μmol per liter), and his international normalized ratio (INR) is 1.1. The emergency department physician contacts the regional poison-control center, which recommends treatment with acetylcysteine.