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Acetaminophen 중독 환자에서 N-Acetylcysteine 투여경로에 따른 치료효과 및 부작용 비교

Other Titles
 Oral vs. Intravenous Administration of N-acetylcysteine in the Acetaminophen Poisoning 
 채효주  ;  이누가  ;  김현종  ;  유제성  ;  정성필  ;  이한식 
 Journal of the Korean Society of Clinical Toxicology (대한임상독성학회지), Vol.10(2) : 97-102, 2012 
Journal Title
 Journal of the Korean Society of Clinical Toxicology  (대한임상독성학회지) 
Issue Date
Purpose: Serious acetaminophen (AAP) poisoning causes hepatotoxicity. N-acetylcysteine (NAC) is the most effective therapy for AAP poisoning and can be administered orally and intravenously (IV). Several studies have compared the efficacy of these two routes of administration and the results have been controversial. The purpose of this study was to compare the efficacy of oral and IV NAC for the prevention of hepatic toxicity in Korean patients whose serum AAP levels were higher than normal. Methods: A retrospective before/after study was performed, in which the patients presented to the emergency department with an AAP overdose from February 1995 to March 2012. A 3-day oral NAC regimen was used in the beginning, and a 20-hr intravenous regimen was then used from 2007. This study assessed the complications of an AAP overdose, such as hepatotoxicity, hepatic failure and renal failure as well as the side effects of the treatment regimen. Results: A total of 41patients was enrolled in this study. The median ALT and AST were 63 (IU/L) and 57 (IU/L) for the oral NAC treated patients, and 14 (IU/L) and 20 (IU/L) for the IV NAC treated patients (p=0.004 and p=0.001, respectively). The incidence of complications was similar in the treatment groups (p=0.399). Among the patients, 7 patients developed hepatotoxicity and were treated successfully with oral or IV NAC. Conclusion: This study suggests that IV NAC and oral NAC can prevent and successfully treat hepatic toxicity in patients whose serum AAP levels are higher than normal.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실)
Yonsei Authors
김현종(Kim, Hyun Jong)
유제성(You, Je Sung)
이누가(Rhee, Nu Ga)
이한식(Lee, Hahn Shick)
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
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