WBR0768

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pharmacology
Sub Category	SubCategory::Pulmonology, SubCategory::General Principles
Prompt	[[Prompt::A 27-year-old woman is brought to the emergency department (ED) with severe abdominal pain and nausea. Her temperature is 36.8 °C (98.24 °F), heart rate is 88/min, and blood pressure is 128/78 mmHg. Her husband arrives to the ED shortly and informs the physician that the patient attempted to commit suicide and ingested more than 20 tables of acetaminophen 5 hours before admission. The physician decides to administer a drug to reduce the effect of acetaminophen toxicity. What is another indication for the same drug that is used to manage this patient's condition?]]
Answer A	AnswerA::Mucolysis
Answer A Explanation	AnswerAExp::N-acetylcysteine is a mucolytic agent that is frequently used to manage patients with cystic fibrosis (CF)
Answer B	AnswerB::Nasal congestion
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 late, awaiting the serum levels of acetaminophen is not be very helpful, and administration of N-acetylcysteine prior to the return of serum concentration of acetaminophen is necessary. Symptoms of acetaminophen overdose are generally non-specific, and typical manifestations include abdominal pain and nausea. N-acetylcysteine is an anti-oxidant that regenerates glutathione and reduces the generation of toxic reactive oxygen species (ROS). It is used to reduce the effect of acetaminophen (paracetamol) toxicity. N-acetylcysteine is also a mucolytic that is usually used to manage patients with cystic fibrosis. Educational Objective: N-acetylcysteine reduces the effect of acetaminophen (paracetamol) toxicity. It is mucolytic agent used to manage patients with cystic fibrosis. References: ]]
Approved	Approved::Yes
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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