Study Set Content:
Glutathione precursor, direct sulfhydryl binding agent, and antioxidant • Used in APAP toxicity
N-acetylcysteine
A sulfhydryl group donor substituting for the usual sulfhydryl donor of the liver (). It rapidly ()or() the highly reactive electrophilic intermediates of metabolism or it may enhance the reduction of the toxic intermediate () to the parent ()
glutathione, binds or detoxifies, NAPQI acetaminophen.
Dose and Route of Administration • PO
140mg/kg LD diluted in juice or soda;
MD:
70mg/kg q4H
N-acetylcysteine adverse effects
• Nausea and vomiting • Rapid IV flushing • Rash • Angioedema • Hypotension • Bronchospasm
Contraindication • Contraindicated for person with hypersensitivity with
NAC
Used for opioid toxicity • Competitive opioid antagonist; 1-2 minutes after IV
Naloxone
longer elimination half-life and duration of action; discontinued in the US
Nalmefene
active PO; prevents recidivism in patients detoxified after opioid abuse and reduces alcohol craving
Naltrexone
is a synthetic and allyl derivative with pure opioid antagonist activity that competitively blocks new kappa and delta opiate receptor within the CNS
Naloxone
Adults: ()mg IV initially, repeat at ()minute intervals; ()mg/h continuous IV (NS or D5%), titrate for effect
0.4-2, 0.4-0.8 2-3
Adverse Effects
• Acute withdrawal symptom
Contraindication • Contraindicated for person with known hypersensitivity with
Naloxone
Specific chelating agent for free iron
Deferoxamine
s water-soluble and renally excreted (orange-pink/vin rose
Red ferrioxamine complex
100mg =
8.5mg elemental iron4.1mg Al in vitro
Used for iron intoxication and aluminum toxicity
Deferoxamine
Dose and ROA • ()mg/kg/h IV and increasing over ()minutes as tolerated, not to exceed ()mg/kg/h
5, 15 , 15
Deferoxamine adverse effects
• Hypotension • Anaphylactoid like reaction
Deferoxamine contraindication
No contraindication
