Intravenous administration of oral N-acetylcysteine

Crit Care Med. 1998 Jan;26(1):40-3. doi: 10.1097/00003246-199801000-00014.

Abstract

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.

MeSH terms

  • Acetaminophen / poisoning*
  • Acetylcysteine / administration & dosage*
  • Acetylcysteine / adverse effects
  • Adolescent
  • Adult
  • Aged
  • Analgesics, Non-Narcotic / poisoning*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Drug Evaluation
  • Drug Overdose / drug therapy
  • Drug Overdose / mortality
  • Drugs, Investigational
  • Female
  • Free Radical Scavengers / administration & dosage*
  • Free Radical Scavengers / adverse effects
  • Humans
  • Infant
  • Infant, Newborn
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Retrospective Studies
  • Safety
  • Survival Rate
  • Treatment Outcome
  • United States
  • United States Food and Drug Administration

Substances

  • Analgesics, Non-Narcotic
  • Drugs, Investigational
  • Free Radical Scavengers
  • Acetaminophen
  • Acetylcysteine