Bet 1: A slower rate of initial N-acetylcysteine infusion in the treatment of acute paracetamol overdose to reduce adverse reactions

Jean-Francois Hibbert recommends Clinical scenario

While on a clinical shift in the emergency department you attend to a 24-year-old female who has taken a clinically significant paracetamol overdose and requires N-acetylcysteine (NAC), you are wondering if a reduction in infusion rate of NAC will reduce adverse side effects such as vomiting and nausea?

Three-part question

In an adult who has taken an acute clinically significant paracetamol overdose requiring treatment, does reducing the rate of the initial dose of NAC reduce adverse effects?

Search strategy

Ovid MEDLINE 1946 to present.

Embase 1974 to 10 January 2018. OR acetaminophen/.exp OR paracetamol OR paracetamol AND Drug Overdose.exp OR OR OR ‘Chemical and drug induced Liver Injury’.exp OR paracetamol OR suicide, attempted.exp, OR self or Suicide.exp AND OR OR OR antidotes.exp OR

Limits: English language and humans.



from Emergency Medicine Journal Best evidence topic reports


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