Citation

Asadzadeh R, Khalighi Z, Mamizadeh N, Hadavi M, Ghaysouri A, Mozafari A. Nephro-Urology Monthly 2021; 13(3).

Copyright

(Copyright © 2021)

DOI

10.5812/numonthly.114074

PMID

unavailable

Abstract

Context: Acetylcysteine is an effective treatment for acetaminophen poisoning. The preparation and dose calculation of acetylcys-teine is associated with medical errors. The prevalence of this error is 34% globally. Case report: A 15-year-old girl took an overdose of acetaminophen in a suicide attempt. Acetylcysteine intravenous was ordered. Due to the medication error by the nurse, she received a 10-fold overdose of intravenous acetylcysteine in both initial loading dose and maintenance dose, at first day. On the second day, the patient showed abdominal pain, nausea, vomiting, and elevated liver enzymes. Her hemoglobin, hematocrit, and platelet quickly decreased. Subsequently, she developed oliguria, anuria, and rising serum creatinine levels. The patient was diagnosed with uremic hemolytic syndrome. She underwent hemodialysis and was treated with plasmapheresis, blood transfusions, and platelets.

DISCUSSION: The effects of acetaminophen poisoning and acetylcysteine overdose may be much more severe and have a greater impact on patient survival than each poisoning alone. Timely and accurate treatment measures can help prevent long-term side effects. © 2021, Author(s).

Language: en

Keywords

human; child; female; case report; abdominal pain; prevalence; hemodialysis; suicide attempt; hospitalization; drug overdose; school child; clinical article; intensive care unit; hot flush; paracetamol; urinalysis; computer assisted tomography; acute kidney failure; erythema; lung edema; pruritus; acetylcysteine; blood transfusion; plasmapheresis; creatinine blood level; bronchoscopy; dyspnea; nausea and vomiting; Acetylcysteine; hemolytic anemia; oliguria; Article; hemoglobin; peritoneal dialysis; thrombocyte; overall survival; anuria; hematocrit; estimated glomerular filtration rate; platelet count; hemolytic uremic syndrome; Medication Error; Renal Failure