A mother brings her 17-year-old daughter to the emergency department. She states that the daughter took 40 extended-release acetaminophen tablets 8 hours ago. The nurse would anticipate an order for
a. activated charcoal.
b. high doses of antacids.
c. acetylcysteine (Mucomyst).
d. hemodialysis.
ANS: C
Liver damage can be minimized by giving acetylcysteine (Mucomyst), a specific antidote to acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen into its nontoxic form when given within 8 to 10 hours.
Because a period of 8 hours has elapsed, it is too late to administer activated charcoal; the medication most likely has already been absorbed.
Antacids, even in high doses, will not correct the problem.
Overdose of acetaminophen is toxic to the liver, not the kidneys, therefore hemodialysis is not indicated.
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