![]() If the acetaminophen concentration cannot be obtained (or is unavailable or uninterpretable) within the 8 hour time interval after acetaminophen ingestion or there is clinical evidence of acetaminophen toxicity: ![]() Obtain an acetaminophen concentration to determine need for continued treatment.Administer a loading dose of acetylcysteine immediately.If the time of acute acetaminophen ingestion is unknown: Acetaminophen concentrations obtained earlier than 4 hours post-ingestion may be misleading as they may not represent maximum acetaminophen concentrations.Ĥ. Obtain a plasma or serum sample to assay for acetaminophen concentration at least 4 hours after ingestion. ![]() Obtain the following laboratory tests to monitor hepatic and renal function and electrolyte and fluid balance: aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, international normalized ratio (INR), creatinine, blood urea nitrogen (BUN), blood glucose, and electrolytes.ģ. The reported history of the quantity of acetaminophen ingested as an overdose is often inaccurate and is not a reliable guide to therapy.Ģ.Assess the history and timing of acetaminophen ingestion as an overdose. For recommendations related to repeated supratherapeutic exposure see Dosage and Administration ( 2.5).ġ. The following recommendations are related to acute acetaminophen ingestion. ![]() ![]() Acetylcysteine Injection Dosage and Administration Pre-Treatment Assessment and Testing Following Acute Acetaminophen Ingestion Expand Indications and Usage for Acetylcysteine InjectionĪcetylcysteine Injection is indicated to prevent or lessen hepatic injury after ingestion of a potentially hepatotoxic quantity of acetaminophen in patients with acute ingestion or from repeated supratherapeutic ingestion (RSI). ![]()
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