(step2CK) Acetaminophen 중독 때 charcoal 준 후 해야 운영자 / 2005-09-16 12:01:32
Acetylcysteine via PO.
Some people alternate other types of OTC pain-relieving drugs, such as aspirin, Advil, and Naprosyn, to avoid using acetaminophen on a daily basis. Alternating their usage may help to reduce their toxicity.If a person attempts to commit suicide by taking an entire bottle of acetaminophen, the emergency room doctor will administer an antioxidant drug called Mucosil (Mucomyst). If administered in time, Mucosil can save the patient's life by inhibiting free-radical damage to the liver caused by acetaminophen-induced depletion of hepatic glutathione (Deleve et al. 1991). The active ingredient in Mucosil is the nutrient N-acetylcysteine (NAC). NAC suppresses the toxic free radicals generated by ingested acetaminophen. If you have to take acetaminophen, we suggest you take 600 mg of the amino acid N-acetyl-cysteine or L-cysteine and at least 1 gram of vitamin C with each dose of acetaminophen.
Note: When using the drug Mucosil
(N-acetyl-cysteine) to treat acute liver failure from acetaminophen overdose, it is crucial that the drug be administered immediately and that it be continued for at least 36 hours in all cases (Clemmesen et al. 1996). Optimal results occur when NAC is administered within 10 hours of acetaminophen overdose. NAC is also effective when given after 15 hours of acetaminophen poisoning (Graudins et al. 1995; Jones 1998). Treatment with N-acetyl-cysteine (NAC) should not be discontinued until all clinical signs of toxicity have subsided. Permanent liver injury can occur if NAC therapy is discontinued too soon. Patients who develop chronic liver failure should be treated with a prolonged course of NAC under a physician's care (Kind et al. 1996).
Another approach to protecting against acetaminophen-induced free-radical liver damage is to take one capsule of a multinutrient formula that contains glutathione, vitamin C, and cysteine with each dose of acetaminophen. This antioxidant formula will provide significant protection to the liver. Additionally, for those who must take acetaminophen chronically, the herb milk thistle (silibinin) may offer some liver protection by increasing the amount of the protective antioxidant glutathione (Zhao et al. 1999). For those whose liver function has been compromised by analgesics or other toxins, treatment with SAMe (S-adenosylmethionine) may help to repair the liver (Lieber 1997).
There are no nutrient supplements known to protect against acetaminophen-induced kidney damage, although the amino acid taurine (1000-3000 mg a day) and high doses of vitamin E succinate (800-1200 IU a day) might be helpful.
