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Colleagues should be aware of this document drawn from : Title: Paracetamol Overdose: New Guidance On Use Of Intravenous Acetylcysteine - Letter From Professor Sir Gordon Duff, Chairman Of The Commission On Human Medicines ________________________________ Problem: I am writing to inform of important new guidance on the use of acetylcysteine for the treatment of acute paracetamol poisoning: The Commission on Human Medicines (CHM) has reviewed the use of acetylcysteine for the treatment of acute paracetamol poisoning and made the following recommendations: The licensed indication for acetylcysteine is now: Paracetamol overdose patients irrespective of the plasma paracetamol level in circumstances where the overdose is staggered or there is doubt over the time of paracetamol ingestion; or Paracetamol overdose patients with a timed plasma paracetamol concentration on or above a single treatment line joining points of 100 mg/L at 4 hours and 15 mg/L at 15 hours nomogram (see Annexe I in attached letter), regardless of risk factors of hepatotoxicity. An increase in the duration of administration of the first dose of intravenous acetylcysteine from 15 minutes to 1 hour. Removal of hypersensitivity as a contraindication to treatment with acetylcysteine. Further information is provided in the attached letter and on the MHRA website: http://www.mhra.gov.uk/Safetyinformation/Safetywarningsalertsandrecalls/Safetywarningsandmessagesformedicines/CON178225 * Acetylcysteine letter and annexes.pdf<https://www.cas.dh.gov.uk/ViewAndAcknowledgment/viewAttachment.aspx?Attachment_id=101488> Additional information: Please also cascade to specialists in acute medicine and paediatrics. You can view further details of this alert by clicking on the following link: View Alert<https://www.cas.dh.gov.uk/ViewAndAcknowledgment/viewAlert.aspx?AlertID=101827> Please do not reply directly to this email as the mailbox is unmonitored, if you have any queries regarding CAS please contact the CAS Helpdesk<mailto:[log in to unmask]> In case your Trust ignores you with best wishes Richard Richard Mainwaring-Burton Consultant Biochemist South London Healthcare Trust Queen Elizabeth Hospital, Woolwich Princess Royal Hospital, Farnborough Queen Mary's Hospital, Sidcup 020-8836-5724 mob: 07831-739876 From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Hallworth Mike (RLZ) Sent: 04 September 2012 09:55 To: [log in to unmask] Subject: NHS Kidney Care AKI Audit Apologies for cross-posting. If anyone is participating in the NHS Kidney Care AKI Audit and has ISoft Telepath as their LIMS, I would be very interested to talk to them about how they are approaching the data collection algorithm. Mike M J Hallworth FRCPath Consultant Biochemist Royal Shrewsbury Hospital Mytton Oak Road Shrewsbury Shropshire SY3 8XQ tel: 01743 261157 fax: 01743 261159 [log in to unmask] ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ******************************************************************************************************************** This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients NHSmail provides an email address for your career in the NHS and can be accessed anywhere ******************************************************************************************************************** ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/