Paracetamol (acetaminophen) poisoning: The early years
Article discusses the management of paracetamol overdose in the ‘early days’, going on to discuss the Rumack-Matthew nomogram, the discovery of the mechanisms of hepatotoxicity, then the use of cysteamine, IV cysteine, oral methionine, and subsequently N-acetylcysteine (NAC).
Source:
British Journal of Clinical Pharmacology
SPS commentary:
The authors note there is still no effective treatment for those with paracetamol poisoning who present late. However, there have been further developments in treatment based on different mechanistic approaches which give hope for effective later treatment, when NAC is no longer effective. They also suggest that one option could be to add a small amount of cysteine to all paracetamol tablets.