PEDIATRICS Vol. 82 No. 4 October 1988, pp. 675-676
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Dosage of Acetylcysteine in Acetaminophen Poisoning

JEFFREY BRENT MD, PHD1, BARRY H. RUMACK MD1, and KENNETH W. KULIG MD2

1 University of Colorado Health Sciences Center, Rocky Mountain Poison Center, Denver
2 Clinical Toxicology, Fellowship Program, Rocky Mountain Poison and Drug Center, Denver

To the Editor.—

The current (11th) edition of the Harriet Lane Handbook contains several serious errors we wish to bring to your attention. These are (1) an incorrect and inadequate 24-hour oral dosage regimen for which there is no scientific basis, (2) a dangerous recommendation for administering oral Mucomyst intravenously, (3) a suboptimal intravenous dosage regimen, (4) the erroneous assertion that N-acetylcysteine (NAC or Mucomyst) therapy is ineffective if initiated longer than ten hours postingestion, and (5) an incorrectly adapted nomogram for determining acetaminophen toxicity.