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급성 Acetaminophen 중독시 복용량에 의한 N-Acetylcystelne의 사용은 적절한가?

Other Titles
 Is N-acetylcysteine Treatment Based on Ingestion Amount Valid in Acute Acetaminophen Overdose Patients? 
 김태근  ;  김민정  ;  이진희  ;  박유석  ;  정성필  ;  이한식 
 Journal of the Korean Society of Clinical Toxicology (대한임상독성학회지), Vol.4(2) : 107-112, 2006 
Journal Title
 Journal of the Korean Society of Clinical Toxicology (대한임상독성학회지) 
Issue Date
Acetaminophen ; Overdose ; N-acetylcysteine
Purpose: In many Korean hospitals, serum acetaminophen concentrations in cases of overdose cannot be measured initially because of inadequate laboratory facilities. Under these circumstances, physicians base the administration of the antidote, N-acetylcysteine, on ingestion amounts as determined by initial history taking. We therefore examined the correlated between ingested amounts and serum acetaminophen concentrations. Methods: Medical records were reviewed retrospectively for patients who presented to the ED with acetaminophen overdose between January 2002 and March 2006. Fifty-nine patients were recruited and sixteen patients were excluded. The forty-three remaining patients were placed into either the high-risk or low-risk group based on their ingested amount (140 mg/kg), and were separately categorized into the toxic or non-toxic group based on their serum acetaminophen concentrations, according to the Rurnack-Matthew nomogram. Results: Ten patients (83.3%) among twelve in the high-risk group were found to have non-toxic serum concentrations, and just one patient (3.2%) among thirty-one in the low-risk group fell into the toxic group based on their serum concentrations. The sensitivity and specificity of risk stratification of the ingested amount as a predictor of intoxication requiring antidote therapy were 66.7% and 75.0%, respectively. Conclusion: This study suggests that the therapeutic decision for acetaminophen overdose should not be based solely on ingested amount only, but requires assessment of acetaminophen concentration.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Lee, Hahn Shick(이한식)
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
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