N-Acetylcysteine-Induced Headache In Hospitalized Patients With Acute Acetaminophen Overdose

Samahjabi's picture
Journal Title, Volume, Page: 
onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0767-3981&date=2011&volume=25&issue=3&spage=405
Year of Publication: 
2011
Authors: 
Sa’ed H. Zyoud
Poison Control And Drug Information Center (PCDIC), An-Najah National University, P.O. Box 7, Nablus, Palestine
Rahmat Awang
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia
Syed Azhar Syed Sulaiman
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia
Samah W. Al-Jabi
Poison Control and Drug Information Center (PCDIC) & College of pharmacy, An-Najah National University, Nablus, Palestine
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

Intravenous N-acetylcysteine (IV-NAC) is usually regarded as a safe antidote to acetaminophen overdose. However, during infusion of the loading dose, adverse drug reactions such as a headache may occur. The objectives of this study were to investigate the prevalence of headache in patients presenting to hospital after acetaminophen overdose and to determine which clinical findings are most predictive of headache among these patients. This is a retrospective cohort study of hospital admissions for acute acetaminophen overdose that was conducted over a period of 4 years from January 1, 2005 to December 31, 2008. Demographic data, clinical characteristics, and predictors of headache were analyzed. spss 15 was used for data analysis. Two-hundred and fifty-five patients were studied; their mean age was 23.1 ± 1.6; 83.9% of them were women and 14.9% had a headache during hospitalization. Headache among patients was significantly associated with IV-NAC administration (P = 0.001), intentional ingestion of drug (P = 0.04), acetaminophen concentration above 'possible toxicity' treatment line (P = 0.04), a high acetaminophen concentration (P = 0.04), and a long hospital stay (P = 0.03). Multiple logistic regression showed a significant risk factor for headache in patients administered IV-NAC (P = 0.04). We recorded a high frequency of headache in patients with acute acetaminophen overdose in our geographical area. This study suggests that among those patients, the use of IV-NAC is associated with an increased risk of headache.

AttachmentSize
N-Acetylcysteine-Induced_Headache_In_Hospitalized_Patients_With_Acute_Acetaminophen_Overdose.pdf95.12 KB