16 N-ACETYLCYSTEINE THERAPY OF CHILDHOOD ACETAMINOPHEN OVERDOSE

Abstract

573 cases of acetaminophen (APAP) ingestion (277 in children under 5 years) have occurred in the Rocky Mountain Region. There were four deaths, all in the adolescent age group, prior to 1976. A multiclinic open national study of N-acetylcysteine (NAC) therapy of APAP overdose since Sept., 1976 has resulted in 88 cases of APAP ingestion in the less than 5 year old. Of these, only 16 had taken more than 140mg/kg by history and would be considered to be at risk for toxicity. Two of these children, in fact, had evidence for toxicity by SGOT elevation and toxic plasma level. Adolescents and young adults, in contrast, contributed 146 cases of APAP overdose with 56 cases in the 12 to 16 year group and 90 cases between the ages of 17 and 21 years. These cases were divided according to time following ingestion and first NAC dose as: I- 0 to 10 hours; II- 10 to 24 hours; and III- no NAC therapy. The data regarding peak SGOT values (IU/L) in each group are given below.