This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Anthony Anker, MD
Oregon Health Science University

Martin J. Smilkstein, MD
Oregon Poison Center Portland

JAMA. 1993;269(10):1252-1253.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—We would like to inform your readers of a disturbing pattern in the treatment of acetaminophen overdoses. The Oregon Poison Center serves a population of 2.5 million people and, like all poison centers, it frequently deals with acetaminophen overdoses. In the last 6 months we have noted three instances in which physicians treating patients with acetaminophen overdoses discontinued acetylcysteine therapy on the basis of serial acetaminophen assays and did not complete the standard course of treatment. When questioned, they stated that the package insert recommended cessation of acetylcysteine therapy when acetaminophen levels were no longer detectable. We believe that this potentially dangerous practice is the result of ambiguous wording. The outcomes for these patients are unknown because after hospital discharge they were not available for follow-up.

The package inserts for at least two available acetylcysteine preparations (Mucosil and Mucomyst) state: "The maintenance dose is then repeated at . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?