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MediumEmergencyAcetaminophen overdoseca-mccqe1ca-rcpsc-em

A 64-year-old man presents to the emergency department one hour after intentionally ingesting an unknown quantity of acetaminophen tablets with alcohol. He is alert and asymptomatic. Serum acetaminophen level at four hours post-ingestion is 180 µmol per litre, which plots above the treatment line on the Rumack-Matthew nomogram. What is the most appropriate management?

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