A 23-year-old woman presents 12 hours after intentional acetaminophen overdose. She reports nausea and vomiting but denies abdominal pain. Vital signs: BP 118/76, HR 102, RR 16, Temp 37.2°C, SpO2 98%. Physical examination reveals no jaundice or hepatomegaly. Laboratory studies show serum acetaminophen level of 85 μg/mL (toxic range). AST and bilirubin remain normal. Which treatment is most appropriate to prevent severe hepatic injury?
- A)Activated charcoal only after 24 hours
- B)N acetylcysteineGABARITO
- C)Fomepizole
- D)Naloxone
- E)Deferasirox
Explicação
Acetaminophen overdose produces the toxic metabolite NAPQI, which is normally detoxified by glutathione. N acetylcysteine replenishes glutathione stores and is most effective when given early to prevent centrilobular hepatic necrosis. Ver explicação completa e trilha adaptativa →