In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region. For general information and inquiries , please call To make an appointment , please call from 7 a. Monday through Friday. Share a comment, compliment or concern.
Tell us what you think about our website - send an email to feedback chp. With m y CHP, you can request appointments, review test results, and more. To pay your bill online, please visit UPMC's online bill payment system. Support the hospital by making a donation online , joining our Heroes in Healing monthly donor program , or visiting our site to learn about the other ways you can give back. Our Sites. Liver Disease States. Liver Transplant. Acetaminophen Toxicity Symptoms Initial symptoms of acetaminophen toxicity can take up to 12 hours to appear.
Acetaminophen Toxicity Treatment Timing is a vital factor in the treatment of acetaminophen toxicity, and therefore doctors attempt to begin treatment of acetaminophen overdose within eight hours of ingestion in order to achieve the best possible outcome for the patient.
Find a Doctor. Contact Us. Pay My Bill. Gender Male Female. Facilities that use the one-bag regimen are already treating all patients with a higher maintenance dose, so adjustment is not usually necessary. This higher maintenance dosing better matches the antidote dose to the higher acetaminophen level.
If NAC therapy is extended beyond the hour initial regimen, the dose rate can be reduced to 6. Alternatively, it is also acceptable to stay on the 2nd bag dose rate This regimen administers the loading dose over 4 hours instead of the traditional 1 hour and has been shown to be as effective as the rapid load in comparative clinical trials.
A slow-load regimen minimizes the incidence of adverse effects, which are related to histamine release. If a patient has already developed an adverse reaction to the standard 1 hour loading dose, such as urticaria, pruritus, or angioedema, treat with diphenhydramine and consider switching to the a slow-load regimen once symptoms resolve. Restart NAC no later than 1 hour after stopping.
Some facilities use this regimen as their primary protocol for acetaminophen overdose in all patients. Oral n-acetylcysteine may have fallen out of favor in many facilities due to the convenience of IV administration; however, it is still a viable treatment option.
Histamine-release reactions are less common, and the drug cost is considerably lower. It is acceptable to dose the oral regimen for only 20 hours in an acute overdose, the same duration as the IV regimen.
This has become a very complicated decision, and a very good reason to engage the Missouri Poison Center in the care of your APAP overdose cases. Every patient needs an individualized decision. This is how our written guideline puts it. ALT is more specific for hepatocellular injury and is used to determine the degree of toxic injury and to plan subsequent interventions.
AST rises and falls faster and is a better indicator of the time course of injury and recovery. AST will decrease first. If you have a patient with acetaminophen overdose, please call the Missouri Poison Center at where specially trained nurses, pharmacists, and medical toxicologist can provide you with the most up-to-date management advice on common and uncommon exposures.
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