Atopic diseases: Risk factor in developing adverse reaction to intravenous N-Acetylcysteine

N-acetylcysteine (nac) is the choice treatment for acetaminophen overdose. the main side effect ofintravenous nac therapy is anap hylaxis or anaphylac toid reactions. we investigated the prevalence of anaphylactoid oranaphy laxis reactions to jv-nac therapy in acetaminophen poisoned patients with atopic disease .methods: a case series antrograde and desc riptive-analytic study was done on acetaminophen poisoned patients whotreated with iv-nac from september 2003 to september 2004 in isfahan, iran.results : of 173 infused iv-nac patie nts, 77 patients (44.5%) developed an anaphy lactoid reaction. its side etfects wasnausea and vomiting (n=49, 63.15%), flashing (n=23, 30.26%), bronchospasm (n=20, 26.31%), vertigo (n=18 , 23.68 %),skin rash (n=25 , 32.36%) and hypotension (n= 12, 15.75%). also, 71 patients (41%) had history of atopic disease. atop icdiseases were asthma (n= 12, 6.9%), atopic derma titis (n=7, 4%), alle rgic rhinitis (n=5, 2.8%) and allerg ic conj unctivitis(n=l , 0.5%). among 71 atopic patients, 59 patie nts (83.13 %) developed side effects to nac. there was a relation betwee nprevious history of atopic disease and anaphylac toid reac tion to nac.conclusions: we report subs tantially higher incidence or anaphylactoid reactions to [v-nac than previous studies .diffe rent atopic diseases must be conside red as a risk facto r in the development of side effects to iv-nac-therapy.