INTRAVENOUS ADMINISTRATION OF ORAL N-ACETYLCYSTEINE

Objective: To report the indications and adverse events associated wit h administration of the oral N-acetylcysteine preparation by the intra venous route. Design: Retrospective consecutive case series analysis o f 226,720 Toxic Exposure Surveillance System data sheets from a certif ied regional poison center during the period January 1, 1992 through D ecember 31, 1993. Setting: A regional poison center certified by the A merican Association of Poison Control Centers. Patients: Seventy six p atients treated with the oral N-acetylcysteine solution by the intrave nous route. Interventions: None. Measurements and Main Results: We rep ort the indications and adverse events associated with the intravenous administration of the oral N-acetylcysteine preparation. Four (4/76, 5.3%) patients developed adverse events attributable to N-acetylcystei ne. None of these events involved hemodynamic, cardiovascular, or pulm onary effects. All reactions occurred during infusion of the initial N -acetylcysteine dose. There were three (3/76, 3.9%) deaths overall; ho wever, they were not attributable to the intravenous administration of the oral N-acetylcysteine preparation. Conclusions: Intravenous admin istration of the oral N-acetylcysteine preparation appears to have lim ited adverse effects and offers another mechanism of delivery of the p otentially lifesaving N-acetylcysteine when oral administration is not possible.