WBR0768

Author	[[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pharmacology
Sub Category	SubCategory::Pulmonology, SubCategory::General Principles
Prompt	[[Prompt::A 27 year old female patient is brought to the emergency department (ED) with severe abdominal pain and nausea. Her vital signs show a temperature of 36.8 degrees C (98.24 degrees F), a heart rate of 88 bpm, and a blood pressure measuring 128/78 mmHg. Her husband arrives to the ED shortly and informs the physician that the patient had ingested more than 20 tables of acetaminophen 5 hours before admission in an attempt to commit suicide. The physician decides to administer a medication to reduce the effect of toxicity. What is another indication for the same medication to be used for this patient's condition?]]
Answer A	AnswerA::Mucolysis
Answer A Explanation	AnswerAExp::N-acetylcysteine is a mucolytic that is frequently used in patients with cystic fibrosis (CF)
Answer B	AnswerB::Decongestion
Answer B Explanation	AnswerBExp::N-acetylcysteine is not a decongestant.
Answer C	AnswerC::Exercise-induced asthma
Answer C Explanation	AnswerCExp::N-acetylcysteine is not generally used to treat exercise-induced asthma.
Answer D	AnswerD::Bronchoconstriction
Answer D Explanation	AnswerDExp::N-acetylcysteine is not generally used to treat bronchoconstriction.
Answer E	AnswerE::Gastoesophageal reflux disease (GERD)
Answer E Explanation	AnswerEExp::N-acetylcysteine is not generally used to treat GERD.
Right Answer	RightAnswer::A
Explanation	[[Explanation::The patient is presenting with acetaminophen (paracetamol) toxicity. When patients present with delay, awaiting the serum levels of acetaminophen may not be very helpful. As such, giving N-acetylcysteine before the serum levels of acetaminophen are available becomes necessary. Symptoms of acetaminophen overdose are generally non-specific, such as abdominal pain and nausea. N-acetylcysteine is an anti-oxidant that may be used to reduce the effect of acetaminophen (paracetamol) toxicity by the regeneration of glutathione and reduction of toxic reactive oxygen species (ROS). N-acetylcysteine is also a mucolytic that is usuaully use in patients with cystic fibrosis. Educational Objective: N-acetylcysteine is used as an antidote to reduce the toxicity of acetaminophen (paracetamol). It is also a mucolytic used in patients with cystic fibrosis. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::acetaminophen, WBRKeyword::paracetamol, WBRKeyword::toxicity, WBRKeyword::overdose, WBRKeyword::suicide, WBRKeyword::attempt, WBRKeyword::commit, WBRKeyword::N-acetylcysteine, WBRKeyword::acetylcysteine, WBRKeyword::antidote, WBRKeyword::glutathione, WBRKeyword::regeneration, WBRKeyword::repletion, WBRKeyword::depletion, WBRKeyword::reactive, WBRKeyword::oxygen, WBRKeyword::species, WBRKeyword::mucolysis, WBRKeyword::mucolytic, WBRKeyword::cystic, WBRKeyword::fibrosis
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