Principles of Poisoning: Part 2/3

What is a nomogram and how does it relate to poisoning? A nomogram is a graph that aids in treatment guidelines for the medical practitioner. Based on the level of drug and the time post ingestion, it basically tells when additional treatment (this would be above and beyond activated charcoal) would be necessary to potentially save the patient’s life.

Here is an example of a nomogram for acetaminophen. When the patient plots in the grey area, we would institute aggressive measures to counteract the effects of the drug… particularly on the liver. Mucomyst is the drug of choice for acetaminophen toxicity.

http://www.merckmanuals.com/professional/print/lexicomp/acetylcysteine.html

Have any of you had experience with acetaminophen toxicity?

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