Practice
Treating acetaminophen overdose
Marco L.A. Sivilotti, Mark C. Yarema and David N. Juurlink
CMAJ April 19, 2022 194 (15) E554; DOI: https://doi.org/10.1503/cmaj.210703
Marco L.A. Sivilotti
Departments of Emergency Medicine, and of Biomedical and Molecular Sciences (Sivilotti), Queen’s University, Kingston, Ont.; Department of Emergency Medicine (Yarema), University of Calgary, Calgary, Alta.; Poison and Drug Information Service, Section of Clinical Pharmacology and Toxicology (Yarema), Alberta Health Services, Calgary, Alta.; Departments of Medicine, of Pediatrics and of Health Policy, Management, and Evaluation (Juurlink), University of Toronto; Ontario Poison Centre (Sivilotti, Juurlink), Hospital for Sick Children, Toronto, Ont.
MD MScMark C. Yarema
Departments of Emergency Medicine, and of Biomedical and Molecular Sciences (Sivilotti), Queen’s University, Kingston, Ont.; Department of Emergency Medicine (Yarema), University of Calgary, Calgary, Alta.; Poison and Drug Information Service, Section of Clinical Pharmacology and Toxicology (Yarema), Alberta Health Services, Calgary, Alta.; Departments of Medicine, of Pediatrics and of Health Policy, Management, and Evaluation (Juurlink), University of Toronto; Ontario Poison Centre (Sivilotti, Juurlink), Hospital for Sick Children, Toronto, Ont.
MDDavid N. Juurlink
Departments of Emergency Medicine, and of Biomedical and Molecular Sciences (Sivilotti), Queen’s University, Kingston, Ont.; Department of Emergency Medicine (Yarema), University of Calgary, Calgary, Alta.; Poison and Drug Information Service, Section of Clinical Pharmacology and Toxicology (Yarema), Alberta Health Services, Calgary, Alta.; Departments of Medicine, of Pediatrics and of Health Policy, Management, and Evaluation (Juurlink), University of Toronto; Ontario Poison Centre (Sivilotti, Juurlink), Hospital for Sick Children, Toronto, Ont.
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Related Articles
- Sivilotti, M. L., Yarema, M. C., & Juurlink, D. N. (2022). Traiter la surdose à l’acétaminophène. CMAJ, 194(24), E859-E860. Accessed April 19, 2024. https://doi.org/10.1503/cmaj.210703-f.
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Treating acetaminophen overdose
Marco L.A. Sivilotti, Mark C. Yarema, David N. Juurlink
CMAJ Apr 2022, 194 (15) E554; DOI: 10.1503/cmaj.210703
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- Acetaminophen overdose remains common
- Clinicians should treat overdoses empirically with acetylcysteine, unless clearly unnecessary
- Acetylcysteine should be continued until the patient meets stopping criteria based on individualized serial testing
- Massive overdose with early-onset coma and lactic acidosis requires more intense treatment
- A medical toxicologist should be consulted for the most current recommendations
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