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Letters |1 December 1996

Use of the Rumack-Matthew Nomogram in Cases of Extended-Release Acetaminophen Toxicity

Susi Vassallo, MD; Abu N.G.A. Khan, MD; Mary Ann Howland, PharmD

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  • New York Regional Poison Control Center, New York, NY 10016.
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TO THE EDITOR:
A 17-year-old healthy girl presented to the hospital after a suicidal ingestion of 13 g of Extended-Relief Tylenol (McNeil Consumer Products Co., Fort Washington, Pennsylvania). She was asymptomatic, and vital signs and physical examination findings were normal. Acetaminophen levels were obtained 3 hours and 5 hours after ingestion. Both values were below the Rumack-Matthew nomogram (Figure 1). While the patient awaited psychiatric consultation, the acetaminophen level was measured for the third time 11 hours after ingestion. The level was 79.8 µg/mL and was in the toxic range when plotted on the nomogram. Oral N-acetylcysteine therapy was begun, and the patient received the standard 72-hour regimen. Liver function test results were monitored every 12 hours and remained normal for the next 89 hours. Results of serum and urine toxicology screens were negative.
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Vassallo S, Khan AN, Howland MA. Use of the Rumack-Matthew Nomogram in Cases of Extended-Release Acetaminophen Toxicity. Ann Intern Med. ;125:940. doi: 10.7326/0003-4819-125-11-199612010-00022

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Published: Ann Intern Med. 1996;125(11):940.

DOI: 10.7326/0003-4819-125-11-199612010-00022

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