N-Acetylcysteine May Protect Against Pesticide Poisoning

N-acetylcysteine, a potent antioxidant and a common treatment for Tylenol overdose, may also be useful in helping people recover from toxic exposures to pesticides, according to a case history reported by physicians in Turkey.

Murat Ozsarac, MD, and his colleagues at Gazi University in Ankara treated an 18-year-old man who was admitted to a hospital emergency room after he consumed three teaspoons of endosulfan in a suicide attempt. Endosulfan is a pesticide used on farms in the United States and in other countries. It is highly toxic and can cause convulsions, headache, dizziness, and loss of balance and muscle control.

The patient was admitted with convulsions and elevated liver enzymes -- his AST topped out at 700 and his ALT reached 178. Normal AST is usually under 42 and normal ALT is usually under 48. Because NAC is used to treat liver toxicity from Tylenol, Özsaraç decided to administer it intravenously in this case. He began with a loading dose of almost 10,000 mg of NAC over 15 minutes, followed by 3,500 mg over four hours, and finally with 7,000 mg over 16 hours.

Within five days, the patient’s liver enzymes returned to normal and he was discharged in good health from the hospital.

Reference: Demircan A, Çalidag E, Özsaraç M, et al. "Acute intoxication by endosulfan: any role of n-acetylcysteine therapy?" Turkish Journal of Medical Sciences, 2008;38:365-367.