N-Acetylcysteine Overdose After Acetaminophen Poisoning

N-Acetylcysteine Overdose After Acetaminophen Poisoning


  • Journal title: International journal of Advanced Biological and Biomedical Research
  • ISSN: 2383-2762 (print)2322-4827 (online)
  • Publisher: CASRP Publishing Company
  • Country of publisher: iran, islamic republic of
  • Date added to EuroPub: 2017/May/15

Subject and more

  • LCC Subject Category: Biological Sciences, Biochemistry, Microbiology, Molecular Biology, Anatomy, Physiology,
  • Publisher's keywords: Anatomy, Biochemistry, Biological Sciences, Cell biology, Clinical Sciences, Comparative Physiology
  • Language of fulltext: english
  • Full-text formats available: PDF


  • Ali Akbar Razlansari | Assistant Professor, Department of Pediatrics, Lorestan University of Medical Sciences, Khorramabad, Iran
  • Azadeh Jafrasteh | Department of Pediatrics, Lorestan University of Medical Sciences, Khorramabad, Iran
  • Mahshid Garmsiri | Medical Student, Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran




N-acetylcysteine (NAC) is a drug used widely and effectively in oral and ‎ intravenous forms as a specific antidote for acetaminophen poisoning. In children ‎ considering the toxic dose of acetaminophen ingested by the patient and the body weight, the ‎ physician prescribes a specific dose of NAC. There is always a risk of iatrogenic overdose of ‎ NAC which can cause different mild to severe temporary or permanent side effects, some of ‎ which can be life threatening. Here we report a rare case of iatrogenic NAC overdose following ‎ an error in calculation of the prescribed dose.‎The patient was a 2.5 years old boy that was brought to emergency room with overdose ‎ of acetaminophen syrup. The Physician prescribed 2 grams of intravenous NAC for him, but ‎ because of the miscalculation of the volume of the drug, the nurse infused about 20 grams of ‎ NAC (10 times the prescribed dose) to the patient. Immediately the patient became drowsy and ‎ developed decreased level of consciousness, stupor, repetitive intractable focal and generalized ‎ convulsions, decrease visual acuity and had prolonged hospitalization in intensive care unit and ‎ pediatric neurologic wards and perhaps will have permanent subtle intellectual and neurologic ‎ sequela. Considering the possible errors in the prescription and administration of some ‎ critical and less commonly used drugs especially those which have several different formulary ‎ and also considering their possible serious and life threatening side effects, it is recommended ‎ that the dose and volume of such medications be calculated meticulously by at least two trained ‎ persons. Also it is important to carry out the administration phases and check the patient’s ‎ symptoms more attentively and cautiously.

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