A patient presents 5 hours after intentionally taking 40 tablets of acetaminophen. What is the antidote?
Answer and explanation
Correct answer: D. N-acetylcysteine, guided by the four-hour plasma level on a treatment nomogram
- Step 1: Acetaminophen overdose can cause liver failure after a symptom-free period. Step 2. N-acetylcysteine replenishes glutathione and works best when given early, and the level at 4 hours indicates the need. Answer: N-acetylcysteine. Why not the others: flumazenil, atropine and naloxone reverse benzodiazepines, organophosphates and opioids.
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