Evaluation of N-Acetyl Cysteine performance in acetaminophen poisoning using certain liver and renal factors in plasma

Background: Annually, acetaminophen poisoning causes probable acute liver and renal failures in different societies. N-acetyl cystein (NAC), first suggested as an effective antidote to fight against acetaminophen poisoning in 1970, prevents the binding of NAPQI to hepatic cells.

Methods: In the present study 30 patients with the average age of 27 and acetaminophen poisoning who referred to the poisons unit of Sina hospital in Tabriz were selected as the study sample. During the 24 hours of hospitalization, the blood samples of the patients were taken and collected in heparinized tubes.  The plasma was separated by centrifuge and kept in tubes in -70°C until it was analyzed by a high performance liquid chromatography method (HPLC) and laboratory analytical kits.

Results: the glutathione peroxidase (GPX) activity difference between the patients and control group was significant at first (P<0.05) but this significant difference disappeared following the treatment. A significant difference was observed in urea level after 24 hours of treatment between the patients and control group (P<0.05). However, at the beginning of the treatment and before administration of NAC, no significant difference was reported between the plasma levels of urea (P>0.05).

Conclusion: The activity level of GPX changed before a tangible change in regular liver enzymes. Urea level increased after 24 hours of treatment despite serum therapy and hydration condition.