Re: [請益] acetaminophen中毒，解毒用藥劑量

[betterday ()]

※ 引述《ERDoctor (苦命爆肝人)》之銘言：
: ※ 引述《porterst (porterst)》之銘言：
: : 各位前輩你們好，
: : 我本身目前在ER工作
: : 想要請教各位有經驗的學姊學長們
: : 遇到acetaminophen中毒
: : 一般會使用Fluimucil (Acetylcysteine)當成解毒劑使用
: : 給予的劑量為 Loading140 mg/kg PO. once
: : 70 mg/kg PO every 4 hours for 17 doses
: : 1.請問IVD給予的劑量算法跟口服劑量算法是一樣的嗎?
: : 2.若執行途徑為IVD，是否應該使用溶液稀釋(如N/S)?
: : 感謝各位
: IV 的給法和口服是不一樣的，目前針對 ACT Overdose 建議的 NAC 給法如下：
: 1. Loading dose: 150 mg/kg in 200 mL D5W run > 60 mins
: 2. Then: 50 mg/kg in 500 mL D5W run > 4 hours
: 3. And then: 100 mg/kg in 1000 mL D5W > 16 hours

引用micromedex的資料:


Acetaminophen overdose:
        oral:

        initial, 140 mg/kg ORALLY, then 70 mg/kg every 4 hr for 17 doses

        starting 4 hr after loading dose.

Acetaminophen overdose:
        IV:

        body weight 40 kg or greater,

        loading dose, 150 mg/kg in 200 mL of compatible solution

        (D5W, 0.45NS, or WFI) IV over 60 minutes,

        then 50 mg/kg in 500 mL of solution IV over 4 hours,

        followed by 100 mg/kg in 1000 mL of solution IV over 16 hours

Acetaminophen overdose:

        IV:

        body weight greater than 20 kg to less than 40 kg:

        loading dose, 150 mg/kg in 100 mL of compatible solution

        (D5W, 0.45NS, or WFI) IV over 60 minutes,

        then 50 mg/kg in 250 mL of solution IV over 4 hours,

        followed by 100 mg/kg in 500 mL of solution IV over 16 hours

Acetaminophen overdose:

        IV:

        body weight 20 kg or less:

        loading dose, 150 mg/kg in 3 mL/kg of compatible solution

        (D5W, 0.45NS, or WFI) IV over 60 minutes,

        then 50 mg/kg in 7 mL/kg of solution IV over 4 hours,

        followed by 100 mg/kg in 14 mL/kg of solution IV over 16 hours

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