A client is hospitalized for ingesting an overdose of acetaminophen. The nurse prepares to administer which specific antidote for this medication overdose?

Appeared in: Central Institute of Psychiatry - 9 July 2022

Explanation

N-acetylcysteine (NAC) is the specific antidote for acetaminophen (paracetamol) overdose.
In an overdose, acetaminophen metabolism produces a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which depletes liver glutathione stores.
The accumulation of NAPQI leads to severe liver cell damage (hepatotoxicity).
N-acetylcysteine works by replenishing glutathione levels, which helps neutralize the toxic NAPQI, and by providing an alternative substrate for conjugation.
Timely administration, ideally within 8 hours of ingestion, is critical to prevent or lessen the severity of liver injury.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological antidote for acetaminophen toxicity to guide bedside assessment, documentation, and the next nursing action.
Recognizing the signs of acetaminophen overdose and knowing the specific antidote, N-acetylcysteine, is a critical nursing responsibility to prevent irreversible liver failure.
The nurse plays a key role in obtaining an accurate ingestion history and monitoring lab values (acetaminophen level, LFTs) to guide treatment with the Rumack-Matthew nomogram.
Patient education is vital. Nurses must teach patients about the dangers of exceeding the maximum daily dose of acetaminophen (4g/day for adults) and the hidden acetaminophen in many over-the-counter combination products.

How to Approach the Question

First, identify the key drug mentioned in the question stem: 'acetaminophen'.
Next, understand the core task: identify the 'specific antidote' for an overdose of this drug.
This is a direct factual recall question common in pharmacology. Access your knowledge base of common poisons and their antidotes.
Systematically evaluate each option: Phytonadione (for Warfarin), Flumazenil (for Benzodiazepines), N-acetylcysteine (for Acetaminophen), and Naloxone (for Opioids).
Select the option that correctly matches the drug in the question. In this case, N-acetylcysteine is the correct match for acetaminophen.

Concept Tested & Keywords

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E6 Pharmacology Katzung 16e p. 103-105

E6 Medicine Davidson Principles Practice 24e p. 158-160

E6 Pharmacology Nursing Lilley 11e Part 1 p. 176-178

Practise the full Central Institute of Psychiatry - 9 July 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.