APPLIED PHARMACOLOGYN-Acetylcysteine Use in Non-Acetaminophen-Induced Acute Liver FailureMcPheeters, Chelsey M. PharmD; VanArsdale, Vanessa M. PharmD, BCPS; Weant, Kyle A. PharmD, BCPSSection Editor(s): Weant, Kyle A. PharmD, BCPS; Column Editor Author Information Department of Pharmacy Services, University of Louisville Hospital, Louisville, Kentucky (Drs McPheeters and VanArsdale); and Department of Pharmacy Services, Medical University of South Carolina, Charleston (Dr Weant). Corresponding Author: Chelsey M. McPheeters, PharmD, Department of Pharmacy Services, University of Louisville Hospital, 530 S Jackson St, Louisville, KY 40202 (firstname.lastname@example.org). Disclosure: The authors report no conflict of interest. Advanced Emergency Nursing Journal: July/September 2016 - Volume 38 - Issue 3 - p 183-189 doi: 10.1097/TME.0000000000000116 Buy Metrics Abstract This article will review the available evidence related to the management of non-acetaminophen induced acute liver failure with N-acetylcysteine. Randomized controlled trials and a meta-analysis were included in this review. The efficacy of N-acetylcysteine in the treatment of acute liver failure from causes other than acetaminophen toxicity was evaluated. The efficacy of N-acetylcysteine in non-acetaminophen-induced acute liver failure is limited to specific patient populations. Patients classified as Coma Grade I or II are more likely to benefit from the use of this agent. The use of N-acetylcysteine is associated with improved transplant-free survival, not overall survival, in adults. N-Acetylcysteine does not improve the overall survival of patients with non-acetaminophen-induced acute liver failure but may be beneficial in those patients with Coma Grades I–II. Liver transplantation remains the only definitive therapy in advanced disease. © 2016 Wolters Kluwer Health, Inc. All rights reserved.