Abstract

Acute acetaminophen ingestion management includes plotting an acetaminophen concentration on the population-based Rumack-Matthew Nomogram. Nomogram implementation reflects an estimate of probability of hepatotoxicity (defined as aspartate or alanine aminotransferase >1,000 IU/L) based on ingestion time and acetaminophen concentration. Similarly, patients with unknown or repeated supratherapeutic acetaminophen exposure are treated with acetylcysteine to mitigate liver injury. Antidote efficacy is time sensitive, however, once hepatotoxicity is identified patients often have extended hospital courses and acetylcysteine administration.

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