Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study
Introduction: N-acetylcysteine (NAC) is the first-line treatment for acetaminophen (APAP) overdose. However, using NAC inappropriately is associated with an increased risk of adverse effects as well as a substantial increase in hospitalization and healthcare costs. This study aims to assess NAC util...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2023;volume=17;issue=2;spage=168;epage=173;aulast=Alaska |
| _version_ | 1797866371347906560 |
|---|---|
| author | Yasser A Alaska Sultan M Alghadeer Abdulaziz A Alrabiah Abdulaziz Harb Bana Almadi |
| author_facet | Yasser A Alaska Sultan M Alghadeer Abdulaziz A Alrabiah Abdulaziz Harb Bana Almadi |
| author_sort | Yasser A Alaska |
| collection | DOAJ |
| description | Introduction: N-acetylcysteine (NAC) is the first-line treatment for acetaminophen (APAP) overdose. However, using NAC inappropriately is associated with an increased risk of adverse effects as well as a substantial increase in hospitalization and healthcare costs. This study aims to assess NAC utilization for acute APAP overdose in the emergency department of a community teaching hospital in Saudi Arabia.
Methods: A retrospective chart review in which the patients initiated on an NAC secondary to acute APAP overdose at KSUMC during the period of June 2015 till November 2018 were included and assessed based on developed validated evident-based protocol for administering NAC for acute APAP ingestion.
Results: A total of 29 patients received NAC treatment for acute APAP overdose; 15 of which were adults, and 14 were pediatrics. Appropriate prescribing of NAC was observed in 14 (48.28%) patients, whereas NAC was inappropriately indicated for 15 (51.72%) patients; 9 of them were adults and 6 patients were pediatric. APAP-Ingestion <150 mg/kg (<200 mg/kg in children) was the most common reason for inappropriate use (n = 7, 46.67%) followed by administering NAC <4 hours post-APAP ingestion (n = 4, 26.67%).
Conclusion: Improper NAC administration appears to be a significant issue among patients with APAP overdose. The utilization of a protocol for the management of APAP overdose will reduce the unnecessary usage of NAC. |
| first_indexed | 2024-04-09T23:24:15Z |
| format | Article |
| id | doaj.art-8410a342ccfc4b929db02c5b6f81d76b |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-04-09T23:24:15Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-8410a342ccfc4b929db02c5b6f81d76b2023-03-21T11:26:55ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2023-01-0117216817310.4103/sja.sja_707_22Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot studyYasser A AlaskaSultan M AlghadeerAbdulaziz A AlrabiahAbdulaziz HarbBana AlmadiIntroduction: N-acetylcysteine (NAC) is the first-line treatment for acetaminophen (APAP) overdose. However, using NAC inappropriately is associated with an increased risk of adverse effects as well as a substantial increase in hospitalization and healthcare costs. This study aims to assess NAC utilization for acute APAP overdose in the emergency department of a community teaching hospital in Saudi Arabia. Methods: A retrospective chart review in which the patients initiated on an NAC secondary to acute APAP overdose at KSUMC during the period of June 2015 till November 2018 were included and assessed based on developed validated evident-based protocol for administering NAC for acute APAP ingestion. Results: A total of 29 patients received NAC treatment for acute APAP overdose; 15 of which were adults, and 14 were pediatrics. Appropriate prescribing of NAC was observed in 14 (48.28%) patients, whereas NAC was inappropriately indicated for 15 (51.72%) patients; 9 of them were adults and 6 patients were pediatric. APAP-Ingestion <150 mg/kg (<200 mg/kg in children) was the most common reason for inappropriate use (n = 7, 46.67%) followed by administering NAC <4 hours post-APAP ingestion (n = 4, 26.67%). Conclusion: Improper NAC administration appears to be a significant issue among patients with APAP overdose. The utilization of a protocol for the management of APAP overdose will reduce the unnecessary usage of NAC.http://www.saudija.org/article.asp?issn=1658-354X;year=2023;volume=17;issue=2;spage=168;epage=173;aulast=Alaskaacetaminophenemergencyn-acetylcysteineoverdoseprotocol |
| spellingShingle | Yasser A Alaska Sultan M Alghadeer Abdulaziz A Alrabiah Abdulaziz Harb Bana Almadi Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study Saudi Journal of Anaesthesia acetaminophen emergency n-acetylcysteine overdose protocol |
| title | Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study |
| title_full | Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study |
| title_fullStr | Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study |
| title_full_unstemmed | Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study |
| title_short | Assessment of N-acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital: A pilot study |
| title_sort | assessment of n acetylcysteine use for acetaminophen overdose in the emergency department of a community teaching hospital a pilot study |
| topic | acetaminophen emergency n-acetylcysteine overdose protocol |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2023;volume=17;issue=2;spage=168;epage=173;aulast=Alaska |
| work_keys_str_mv | AT yasseraalaska assessmentofnacetylcysteineuseforacetaminophenoverdoseintheemergencydepartmentofacommunityteachinghospitalapilotstudy AT sultanmalghadeer assessmentofnacetylcysteineuseforacetaminophenoverdoseintheemergencydepartmentofacommunityteachinghospitalapilotstudy AT abdulazizaalrabiah assessmentofnacetylcysteineuseforacetaminophenoverdoseintheemergencydepartmentofacommunityteachinghospitalapilotstudy AT abdulazizharb assessmentofnacetylcysteineuseforacetaminophenoverdoseintheemergencydepartmentofacommunityteachinghospitalapilotstudy AT banaalmadi assessmentofnacetylcysteineuseforacetaminophenoverdoseintheemergencydepartmentofacommunityteachinghospitalapilotstudy |