A 24-year-old is brought 10 hours after ingesting an unknown number of acetaminophen tablets with alcohol. She has nausea, normal vital signs and AST

Question

A 24-year-old is brought 10 hours after ingesting an unknown number of acetaminophen tablets with alcohol. She has nausea, normal vital signs and AST 42 U/L. The reported time is unreliable and the acetaminophen level will not return for two hours. What is the most appropriate initial management?

Accepted Answer

Start N-acetylcysteine now while obtaining acetaminophen concentration and liver tests

Answer

Give activated charcoal as sole therapy at 10 hours

Answer

Discharge if the first INR is normal

Answer

Administer flumazenil for hepatoprotection

Answer

Delay antidote until transaminases are markedly elevated

Acetaminophen overdose — RCPSC EM MCQ

A 24-year-old is brought 10 hours after ingesting an unknown number of acetaminophen tablets with alcohol. She has nausea, normal vital signs and AST 42 U/L. The reported time is unreliable and the acetaminophen level will not return for two hours. What is the most appropriate initial management?