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Pediatric Rounds Review Questions
A Lethargic Infant with Vomiting

Answer 1

  1. 140 mg/kg. The initial dose of NAC is 140 mg/kg body weight, followed by 70 mg/kg every 4 hours for 72 hours (total of 17 doses). Treatment with oral NAC is most effective in preventing hepatotoxicity if begun within 8 hours of ingestion, regardless of the initial acetaminophen concentration. Although effectiveness decreases with time, oral NAC is safe and effective as many as 24 hours after a toxic ingestion.

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