Utility of acetylcysteine in treating poisonings and adverse drug reactions

Peter Chyka, Adrianne Y. Butler, Billie J. Holliman, Martin I. Herman

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

As recognition of the role of free radicals and reactive toxins in the pathogenesis of disease, poisoning, and adverse drug reactions has evolved, interest in the use of acetylcysteine as a modulator of these effects has steadily increased in recent years. Acetylcysteine is commonly thought to serve as a glutathione precursor and consequently can increase or sustain intracellular glutathione which scavenges reactive oxygen species caused by toxins or subsequent tissue injury. At least 10 additional mechanisms of action for acetylcysteine have been demonstrated in various laboratory models, but a unifying framework of its actions is still to be proposed. This paper reviews the current experimental and therapeutic status of acetylcysteine for the treatment of poisonings and adverse drug reactions. Of the 45 potential uses of acetylcysteine that were identified for the treatment of poisonings or adverse drug reactions, 14 of the toxic effects have little support for its use while promising results have been demonstrated for 27 toxicities. Currently, treatment of acute paracetamol (acetaminophen) poisoning is the only widely accepted clinical indication for acetylcysteine as a treatment for poisoning or adverse drug reactions. In many clinical situations acetylcysteine is used empirically utilising modifications of dosage regimens employed for paracetamol poisoning. Often it is difficult to determine the benefit of therapy with acetylcysteine owing to the nature of the toxicity being treated, the use of other therapies, the presence of comorbid conditions, and the small number of patients studied. The diverse and positive nature of the investigations suggest that there is considerable promise in acetylcysteine as a research tool and pharmacological agent.

Original languageEnglish (US)
Pages (from-to)123-148
Number of pages26
JournalDrug Safety
Volume22
Issue number2
DOIs
StatePublished - Jan 1 2000

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Acetylcysteine
Drug-Related Side Effects and Adverse Reactions
Poisoning
Pharmaceutical Preparations
Acetaminophen
Therapeutics
Glutathione
Toxicity
Poisons
Modulators
Free Radicals
Reactive Oxygen Species
Pharmacology
Tissue
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Toxicology
  • Pharmacology
  • Pharmacology (medical)

Cite this

Utility of acetylcysteine in treating poisonings and adverse drug reactions. / Chyka, Peter; Butler, Adrianne Y.; Holliman, Billie J.; Herman, Martin I.

In: Drug Safety, Vol. 22, No. 2, 01.01.2000, p. 123-148.

Research output: Contribution to journalReview article

Chyka, Peter ; Butler, Adrianne Y. ; Holliman, Billie J. ; Herman, Martin I. / Utility of acetylcysteine in treating poisonings and adverse drug reactions. In: Drug Safety. 2000 ; Vol. 22, No. 2. pp. 123-148.
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