PURPOSE OF REVIEW Acetaminophen poisoning accounts for a disproportionate percentage of all toxic ingestions, and can be life-threatening. This article reviews the mechanism and presentation of acetaminophen toxicity, as well as its treatment, including current thinking and treatment recommendations. RECENT FINDINGS N-acetylcysteine acts to detoxify acetaminophen in several ways, but primaril...

An Update of N-acetylcysteine Treatment for Acute Acetaminophen Toxicity in Children. Marzullo L. Curr Opin Pediatr. 2005;17(2):239–245 Acetaminophen Toxicity in Children. American Academy of Pediatrics. Committee on Drugs. Pediatrics. 2001; 108(4):1020–1024 Clinical Report—Fever and Antipyretic Use in Children. Section on Clinical Pharmacology and Therapeutics; Committee on Drugs, Sullivan JE,...

We present a 3-month-old female who developed fulminant hepatic failure after ingesting less than 8 mL of clove oil. Initial treatment involved gastrointestinal decontamination, supportive measures, and admission to hospital. She subsequently developed fulminant hepatic failure and was treated with intravenous N-acetylcysteine (N-AC) according to a protocol used for acetaminophen poisoning. Ove...

The incidence of aspirin (acetylsalicylic acid [ASA]) overdose and related childhood deaths has decreased significantly in recent years. Reasons include pediatricians’ preference for acetaminophen preparations, the Food and Drug Administration’s mandate limiting 36 tablets of baby aspirin to each bottle, and the use of child-resistant caps. Unfortunately, the severity of this poisoning may be u...

the management of various medical conditions such as chronic bronchitis and acetaminophen poisoning, and in tracheostomy care. We report its use as a mucolytic agent in the treatment of peripancreatic collections after necrosectomy for acute pancreatitis, and its effect on patient recovery. van Waes and colleagues in 1983 demonstrated the efficacy of NAC in breaking down the viscosity of drain ...

1. Understand the epidemiology of pediatric poisonings and explain how developmental milestones influence behavior that may lead to a poisoning exposure. 2. Perform a focused toxicologic physical examination and describe the various toxidromes. 3. Explain the primary acid-base disturbance in salicylate toxicity. 4. Determine which patient requires treatment after acute acetaminophen ingestion. ...