ACETAMINOPHEN NOMOGRAM PDF

We studied the frequency of acetaminophen concentrations drawn within 4 h post ingestion and whether the Rumack-Matthew nomogram was properly used in making acetylcysteine treatment decisions. Cases were analyzed for demographics, timing of acetaminophen concentrations, and application of the Rumack-Matthew nomogram in acetylcysteine initiation or termination. Results: 1, cases of acute acetaminophen exposure were reviewed. Prehour acetaminophen concentrations cannot be used to determine the need for acetylcysteine therapy and are associated with an increased likelihood of not obtaining optimally timed acetaminophen concentrations and acetylcysteine management not based on the proper application of the Rumack-Matthew nomogram. Current practice results in additional cost, unnecessary treatment, potential adverse medication effects, and the possibility of non-treatment of patients at risk of hepatotoxicity.

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We studied the frequency of acetaminophen concentrations drawn within 4 h post ingestion and whether the Rumack-Matthew nomogram was properly used in making acetylcysteine treatment decisions. Cases were analyzed for demographics, timing of acetaminophen concentrations, and application of the Rumack-Matthew nomogram in acetylcysteine initiation or termination.

Results: 1, cases of acute acetaminophen exposure were reviewed. Prehour acetaminophen concentrations cannot be used to determine the need for acetylcysteine therapy and are associated with an increased likelihood of not obtaining optimally timed acetaminophen concentrations and acetylcysteine management not based on the proper application of the Rumack-Matthew nomogram.

Current practice results in additional cost, unnecessary treatment, potential adverse medication effects, and the possibility of non-treatment of patients at risk of hepatotoxicity.

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Similar articles Nomogram line crossing after acetaminophen combination product overdose. Kirschner RI, et al. Clin Toxicol Phila. Epub Nov PMID: Changing nomogram risk zone classification with serial testing after acute acetaminophen overdose: a retrospective database analysis. Mutsaers A, et al. Epub Jan Risk prediction of hepatotoxicity in paracetamol poisoning. Wong A, Graudins A. Wong A, et al. Epub Apr PMID: Review. Shorter duration of oral N-acetylcysteine therapy for acute acetaminophen overdose.

Woo OF, et al. Ann Emerg Med. Treatment of acetaminophen overdose. Zed PJ, et al. Am J Health Syst Pharm. Show more similar articles See all similar articles. Publication types Multicenter Study Actions. Observational Study Actions. Research Support, N. Adolescent Actions. Adult Actions. Child Actions. Dose-Response Relationship, Drug Actions. Female Actions. Humans Actions. Male Actions. Retrospective Studies Actions.

Toxicity Tests, Acute Actions. Young Adult Actions. Substances Analgesics, Non-Narcotic Actions. Acetaminophen Actions. Acetylcysteine Actions. Copy Download.

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Nomogram Line Crossing After Acetaminophen Combination Product Overdose

The Rumack-Matthew nomogram , also known as Rumack-Matthews nomogram or the acetaminophen nomogram is an acetaminophen toxicity nomogram plotting serum concentration of acetaminophen against the time since ingestion in an attempt to prognosticate possible liver toxicity as well as allowing a clinician to decide whether to proceed with N-Acetylcysteine NAC treatment or not. It is a logarithmic graph starting not directly from ingestion, but from 4 hours post ingestion after absorption is considered likely to be complete. In hands of skilled clinicians this nomogram allows for timely management of acetaminophen overdose. This nomogram is not used alone if the patient has altered mental status or if the history is not reliable. Rather, a second level should be drawn and plotted to see if the slope of the line remains at or above the nomogram. A formal half life may also be determined. If half-life is more than 4 hours, then treatment is necessary to prevent hepatotoxicity and liver failure.

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Rumack-Matthew nomogram

Enter your email address and we'll send you a link to reset your password. Please fill out required fields. Serum acetaminophen concentration should be sent in all patients presenting with intentional overdose or those using excessive amounts of acetaminophen containing products. NAC treatment should be initiated within 8 hours post-ingestion to decrease risk of hepatotoxicity.

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