Intravenous administration of oral N-acetylcysteine

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Abstract
To report the indications and adverse events associated with administration of the oral N-acetylcysteine preparation by the intravenous route. 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. A regional poison center certified by the American Association of Poison Control Centers. Seventy-six patients treated with the oral N-acetylcysteine solution by the intravenous route. None. 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. 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. (Crit Care Med 1998; 26:40-43)