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Intravenous administration of oral N-acetylcysteine

Yip, Luke MD; Dart, Richard C. MD, PhD; Hurlbut, Katherine M. MD

Clinical Investigations

Objective To report the indications and adverse events associated with administration of the oral N-acetylcysteine preparation by the intravenous route.

Design Retrospective consecutive case series analysis of 226,720 Toxic Exposure Surveillance System data sheets from a certified regional poison center during the period January 1, 1992 through December 31, 1993.

Setting A regional poison center certified by the American Association of Poison Control Centers.

Patients Seventy-six patients treated with the oral N-acetylcysteine solution by the intravenous route.

Interventions None.

Measurements and Main Results We report the indications and adverse events associated with the intravenous administration of the oral N-acetylcysteine preparation.

Four (4/76, 5.3%) patients developed adverse events attributable to N-acetylcysteine. None of these events involved hemodynamic, cardiovascular, or pulmonary effects. All reactions occurred during infusion of the initial N-acetylcysteine dose. There were three (3/76, 3.9%) deaths overall; however, they were not attributable to the intravenous administration of the oral N-acetylcysteine preparation.

Conclusions Intravenous administration of the oral N-acetylcysteine preparation appears to have limited adverse effects and offers another mechanism of delivery of the potentially lifesaving N-acetylcysteine when oral administration is not possible. (Crit Care Med 1998; 26:40-43)

From the Rocky Mountain Poison and Drug Center and Denver Health Medical Center (Drs. Yip, Dart, and Hurlbut), Department of Surgery (Drs. Yip, Dart, and Hurlbut), and Department of Medicine and School of Pharmacy (Dr. Dart), University of Colorado Health Science Center, Denver, CO.

Address requests for reprints to: Dr. Richard C. Dart, Rocky Mountain Poison and Drug Center, 8802 East 9th Avenue, Denver, CO 80220.

© Williams & Wilkins 1998. All Rights Reserved.