Authors' reply to Thomas and colleagues

Title: Authors' reply to Thomas and colleagues
Creator: Buckley, Nicholas A.; Dawson, Andrew H.; Isbister, Geoffrey K.
Relation: BMJ Vol. 353
Publisher Link: http://dx.doi.org/10.1136/bmj.i3461
Publisher: BMJ Group
Resource Type: journal article
Date: 2016
Description: We agree with Thomas and colleagues that evidence to date has shown the updated guidance on acetylcysteine to be an expensive strategy with no demonstrable net benefit: frequent adverse effects of acetylcysteine possibly outweigh the postulated small reduction in severe hepatotoxicity. Moreover, the change has generated conflicting advice on threshold doses for initiating treatment. Current advice in the toxicology database TOXBASE, when paracetamol concentrations cannot be used for guidance, is to treat an acute overdose when >150 mg/kg is ingested. However, 75 mg/kg is used in many UK sources, including a flow chart on the Royal College of Emergency Medicine website, NHS trust guidelines and a 2015 BMJ Best Practice monograph.
Subject: paracetamol posioning; treatment; acetylcysteine
Identifier: http://hdl.handle.net/1959.13/1316430
Identifier: uon:23169
Identifier: ISSN:0959-8146
Language: eng