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Previous Volume 349:1974-1976 November 13, 2003 Number 20 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In his otherwise excellent review of drug-induced liver injury, Lee asserts that N-acetylcysteine reliably prevents liver injury if treatment is begun within 12 to 24 hours after the ingestion of acetaminophen. This is incorrect.

N-acetylcysteine is almost universally effective when given within 8 to 10 hours after an acute overdose of acetaminophen, but its antidotal efficacy decreases substantially thereafter.^1,2 Most patients presenting after a delay should still receive the antidote,^1,3 but clinicians should remain vigilant for evidence of acute liver failure in such cases.

David N. Juurlink, M.D., Ph.D.
University of Toronto
Toronto, ON M4N . . . [Full Text of this Article]

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