PEDIATRICS Vol. 62 No. 5s November 1978, pp. 898-903
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Acetaminophen Overdose: Incidence, Diagnosis, and Management in 416 Patients

Barry H. Rumack M.D.1 and Robert G. Peterson M.D., Ph.D.1

1 Departments of Pediatrics, Medicine, and Pharmacology, and the Division of Clinical Pharmaeology, University of Colorado Medical Center, Denver, and the Rocky Mountain Poison Center. Denver General Hospital

Acetaminophen overdose was studied in 416 patients as part of a nationwide multiclinic open study. Twenty-seven percent of the patients were toxic by plasma acetaminophen level. The 12- to 21-year-old age group had the highest incidence of toxic blood levels (47%). Children under age 5 had the mildest toxicity of any age group; only two of 16 patients had toxic blood levels. No relationship to subsequent Reye's syndrome could be demonstrated. Acetylcysteine is a safe, effective treatment if administered within the first ten hours; it has some efficacy with no toxicity if used after ten hours. Acetylcysteine has advantages over both cysteamine and methionine. All patients in this study recovered with no sequelae.