N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?

Background and Aim of Study: Rodenticide is a commonly ingested poison in India. Many rodenticides contain hepatotoxic agents and can cause acute liver failure (ALF). There is no antidote for rodenticide poison, and consumption is often fatal. The Role of N acetyl cysteine (NAC) in acetaminophen...

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Main Authors: Smitha Bhat, Kumar P. Kenchetty
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2015-01-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/5455/11484_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf
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author Smitha Bhat
Kumar P. Kenchetty
author_facet Smitha Bhat
Kumar P. Kenchetty
author_sort Smitha Bhat
collection DOAJ
description Background and Aim of Study: Rodenticide is a commonly ingested poison in India. Many rodenticides contain hepatotoxic agents and can cause acute liver failure (ALF). There is no antidote for rodenticide poison, and consumption is often fatal. The Role of N acetyl cysteine (NAC) in acetaminophen induced ALF is well established. Additionally some studies have shown that it may be useful in non-acetaminophen induced ALF also. Cases with ALF secondary to suicidal rodenticide consumption have been reported, and some reports show that NAC is beneficial in these cases. Our study was a retrospective analysis of patients admitted with rodenticide consumption, comparing outcomes in those receiving standard of care management and those who were treated with NAC also. Materials and Methods: Case sheets of all inpatients of a tertiary medical college hospital between January 2010 and December 2012 admitted with an alleged history of rodenticide consumption were surveyed and data was extracted and analysed. Statistical Analysis: Patients were analysed with respect to age, sex, mode of presentation, interval between consumption of rodenticide and starting NAC; the outcome in patients treated with acetylcysteine was compared to outcomes in those not treated with acetylcysteine Results: A total of 100 patients were studied out of which 18 died. Sixteen of the deaths were in patients who had not been treated with NAC. We found that patients who had received NAC had lower mortality, lower peak values of AST/ALT, and shorter hospital stay. Conclusion: NAC may have a role in the management of ALF associated with rodenticide consumption.
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spelling doaj.art-b793412788c34cefb9cd81b9b98fc7452022-12-21T23:18:28ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2015-01-0191OC10OC1310.7860/JCDR/2015/11484.5455N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?Smitha Bhat0Kumar P. Kenchetty1Professor, Department of Medicine, Father Muller Medical College, Mangalore, India.Post Graduate Resident, Department of Medicine, Father Muller Medical College, Mangalore, India.Background and Aim of Study: Rodenticide is a commonly ingested poison in India. Many rodenticides contain hepatotoxic agents and can cause acute liver failure (ALF). There is no antidote for rodenticide poison, and consumption is often fatal. The Role of N acetyl cysteine (NAC) in acetaminophen induced ALF is well established. Additionally some studies have shown that it may be useful in non-acetaminophen induced ALF also. Cases with ALF secondary to suicidal rodenticide consumption have been reported, and some reports show that NAC is beneficial in these cases. Our study was a retrospective analysis of patients admitted with rodenticide consumption, comparing outcomes in those receiving standard of care management and those who were treated with NAC also. Materials and Methods: Case sheets of all inpatients of a tertiary medical college hospital between January 2010 and December 2012 admitted with an alleged history of rodenticide consumption were surveyed and data was extracted and analysed. Statistical Analysis: Patients were analysed with respect to age, sex, mode of presentation, interval between consumption of rodenticide and starting NAC; the outcome in patients treated with acetylcysteine was compared to outcomes in those not treated with acetylcysteine Results: A total of 100 patients were studied out of which 18 died. Sixteen of the deaths were in patients who had not been treated with NAC. We found that patients who had received NAC had lower mortality, lower peak values of AST/ALT, and shorter hospital stay. Conclusion: NAC may have a role in the management of ALF associated with rodenticide consumption.https://jcdr.net/articles/PDF/5455/11484_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdffulminant hepatic failurehepatotoxicpoisoning
spellingShingle Smitha Bhat
Kumar P. Kenchetty
N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?
Journal of Clinical and Diagnostic Research
fulminant hepatic failure
hepatotoxic
poisoning
title N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?
title_full N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?
title_fullStr N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?
title_full_unstemmed N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?
title_short N-Acetyl Cysteine in the Management of Rodenticide Consumption — Life Saving?
title_sort n acetyl cysteine in the management of rodenticide consumption life saving
topic fulminant hepatic failure
hepatotoxic
poisoning
url https://jcdr.net/articles/PDF/5455/11484_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf
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