The In Vitro Effect of N‐Acetylcysteine on Prothrombin Time in Plasma Samples From Healthy Subjects

ACADEMIC EMERGENCY MEDICINE 2011; 18:351–354 © 2011 by the Society for Academic Emergency Medicine Objectives:  In the treatment of acetaminophen toxicity, clinicians believe that N‐acetylcysteine (NAC) artificially elevates prothrombin time (PT), potentially obscuring signs of liver damage. However...

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Vydáno v:Academic emergency medicine Ročník 18; číslo 4; s. 351 - 354
Hlavní autoři: Pizon, Anthony F., Jang, David H., Wang, Henry E.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Oxford, UK Blackwell Publishing Ltd 01.04.2011
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Témata:
Acetaminophen - poisoning
Acetylcysteine - adverse effects
Acetylcysteine - pharmacology
Adult
Blood
Blood Coagulation - drug effects
Dose-Response Relationship, Drug
Drug therapy
Emergency medical care
Female
Humans
Liver
Male
Pharmaceuticals
Plasma
Prothrombin Time
Toxicity
ISSN:1069-6563, 1553-2712, 1553-2712
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Shrnutí:ACADEMIC EMERGENCY MEDICINE 2011; 18:351–354 © 2011 by the Society for Academic Emergency Medicine Objectives:  In the treatment of acetaminophen toxicity, clinicians believe that N‐acetylcysteine (NAC) artificially elevates prothrombin time (PT), potentially obscuring signs of liver damage. However, the effect of NAC on human blood coagulation remains unverified. The purpose of this study was to evaluate the effect of NAC on PT prolongation in human plasma. Methods:  The authors obtained blood samples from 33 volunteer subjects. The blood plasma samples were divided into four 1‐mL aliquots. The first aliquot was used as a control. To three additional aliquots, varying amounts of NAC were added, maintaining constant volume with a maximum dilution of 0.5%. The four concentrations of NAC (control, 250, 500, or 1,000 mg/L) were incubated at 37°C for 1 hour, and PT was measured. PT values were compared using fixed effects regression. Results:  Mean (± standard deviation [SD]) PT values for the control, 100, 500, and 1,000 mg/L NAC values were 13.9 (±1.01), 14.2 (±1.08), 15.5 (±1.21), and 17.4 (±1.72) seconds, respectively. At the 1,000 mg/L concentration, two PTs exceeded 22 seconds, and half exceeded 17 seconds. PT increased with NAC concentrations (fixed effects regression p < 0.001) in a dose‐dependent manner. Conclusions:  In this in vitro human model, NAC had a dose‐dependent effect on PT.
Bibliografie:The authors have no relevant financial information or potential conflicts of interest to disclose.
A related commentary appears on page 428.
Supervising Editor: Richard Sinert, DO.
Presented at the North American Congress of Clinical Toxicology, Toronto, Ontario, Canada, 2008.
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ISSN:1069-6563
1553-2712
1553-2712
DOI:10.1111/j.1553-2712.2011.01041.x