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February 28-March 01, 2019 | Paris, France
Palliative Care, Obstetrics and Gynecology
Stroke and Clinical Trials
International Conference on
Joint Event on
International Conference on
&
Journal of Research and Reports in Gynecology and Obstetrics | Volume: 3
Recovery of acetaminophen-induced fulminant hepatic failure and encephalopathy after ten days of
intravenous N-acetylcysteine administration in twin boys
Abdullah Altamimi, Ahmed Abusibah, Ali Almajed, Faisal Al Ghamdi, Saleh Al Manea
and
Barrak Al Dosary
KFMC, Saudi Arabia
A
cetaminophen is considered a safe medication and is
a favored analgesic and antipyretic [1-7]. Despite this,
frequent use of unintended inappropriate dosing or failure
to recognize the risks associated with standard dosing can
contribute to acetaminophen toxicity. Twins aged 10 months
were admitted to a primary hospital due to a viral infection
lasting for five days and were treated with acetaminophen
and antibiotics. Their condition worsened and they were
transferred to tertiary hospitals. Twin 2 was brought to
KFMC, and twin 1 was admitted to another hospital. As per
medical report, twin 1 received 160mg acetaminophen orally
(120 mg/kg/day) and twin 2 was (96 mg/kg/day) for five
days, after which the patients’ conditions did not improve.
Despite acetaminophen therapy, the fevers continued, and
they developed diarrhoea and vomiting. Treatment twin 1
acetaminophen levels of 80 µmol/L, an intravenous loading
dose of N-acetylcysteine was initiated at 150 mg/kg over 1
h, followed by a second dose of N-acetylcysteine of 50 mg/
kg over 4 h, and finally 100 mg/kg N-acetylcysteine over 16
h per day for three days. Treatment twin 2 a loading dose
of NAC was initiated at 150 mg/kg over 1 h, followed by
a second iv dose of 50 mg/kg NAC over 4 h. Then, 300 ml
of fresh frozen plasma and 5 mg of vitamin K was given by
the i.v, followed immediately by 100 mg/kg NAC over 16 h
and continued at 10 mg/kg/hour thereafter. The rate was
reduced to 6.25 mg/kg/hour after three consecutive ALT
level results of <1000 IU/L and normalization of INR. There
was no further bleeding after 48 h of NAC administration.
Both patients were discharged, after one-month check –up
both infants were fine.
Conclusions:
Although paracetamol toxicity is uncommon,
it is important that physicians need to provide adequate
counseling to parents regarding its use in the management
of fever during viral illnesses.
Speaker Biography
Abdullah Altamimi is a medical consultant with an expertise in Paediatric emergency
and medical toxicology. He earned his medical degree at King Saud University Medical
College. He completed his paediatric residency program at King Saud Medical City and
completed his fellowship in paediatric emergency program at King Abdulaziz Medical
City. He attended and joined several fellowship trainings in Paediatric emergency at
University of Toronto and in medical toxicology at Emory University Georgia USA. He
was a member of Arab Board general paediatric at Damascus Syria and Saudi Board
Paediatric Emergency. He has authored numerous journals related to toxicology and
acetaminophen.
e:
Tamimi7a@gmail.comAbdullah Altamimi et al.
, Res Rep Gynaecol Obstet, Volume 3
DOI: 10.4066/2591-7366-C1-003