Elsevier

Annals of Emergency Medicine

Volume 24, Issue 3, September 1994, Pages 538-539
Annals of Emergency Medicine

A new loading dose for N-acetylcysteine? The answer is no

https://doi.org/10.1016/S0196-0644(94)70193-8Get rights and content

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To the Editor:

The title "Use of Activated Charcoal in a Simulated Poisoning With Acetaminophen: A New Loading Dose for N-Acetylcysteine?" [September 1993;22:1398-1402] is a question. In response, the answer is "No." Including this study, by Chamberlain et al, there are still no data that support increasing the N-Acetylcysteine (NAC) loading dose for patients receiving activated charcoal. In fact, the notion that activated charcoal-NAC interaction is still an important unresolved issue deserves to be buried

In Reply:

We thank Dr Smilkstein for his comments. Many of his statements concerning our study conflict with current expert consensus opinion and are unsubstantiated by available data concerning NAC efficacy.

In his first paragraph, Dr Smilkstein states that "the notion that activated charcoal-NAC interaction is still an important unresolved issue deserves to be buried . . . ." This statement is not supported by Poisindex. The 1993 edition of Poisindex (edited by Barry Rumack, an authority on

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