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Interaction Between N ‐Acetylcysteine and Activated Charcoal: Implications for the Treatment of Acetaminophen Poisoning
Author(s) -
Tenenbein Paul K.,
Sitar Daniel S.,
Tenenbein Milton
Publication year - 2001
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.21.17.1331.34427
Subject(s) - activated charcoal , acetaminophen , salicylic acid , charcoal , acetylcysteine , chemistry , adsorption , activated carbon , chromatography , pharmacology , medicine , organic chemistry , biochemistry , antioxidant
Study Objective. To determine if the presence of N ‐acetylcysteine reduces the ability of activated charcoal to adsorb acetaminophen both in the absence and presence of a coingestant. Design. In vitro laboratory study. Setting. University hospital research laboratory. Measurements and Main Results. The adsorption of acetaminophen and salicylic acid by activated charcoal in the presence and absence of N ‐acetylcysteine was measured in vitro. Acetaminophen and salicylic acid analyses were conducted with high‐performance liquid chromatography. Adsorption data were compared using the appropriate parametric statistical test. The addition of N ‐acetylcysteine significantly decreased the binding of acetaminophen by activated charcoal (p<0.005). When salicylic acid was added to simulate a coingestant, N ‐acetylcysteine significantly decreased salicylate adsorption by charcoal (p<0.001). Conclusions. The presence of N ‐acetylcysteine reduces the ability of activated charcoal to adsorb acetaminophen and coingestants. In vivo data will be required to determine the clinical relevance of these interactions.