Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · May 1997
Case Reports[Anaphylactic reaction to N-acetylcysteine after poisoning with paracetamol].
Paracetamol is among the most common substances consumed in self-poisoning attempts. The recommended treatment is intravenous N-acetylcysteine. Adverse reactions to this treatment are relatively common, but are rarely serious. ⋯ This reaction was most probably an acute toxic effect of N-acetylcysteine, and not a result of an immunologic hypersensitivity reaction. Reducing the infusion rate of the initial loading dose might reduce the risk of adverse reactions. Recent guidelines recommend giving the loading dose over 60 minutes, instead of 15 minutes.
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Tidsskr. Nor. Laegeforen. · May 1997
Case Reports[Practical problems associated with long-term opioid therapy].
Long-term opioid therapy results in physical dependency. Therefore abrupt cessation of opioid treatment may cause acute abstinence symptoms. The doses of opioids should always be reduced gradually, even when other treatment options give good pain relief. ⋯ Inappropriate use of naloxone in these patients can also result in acute abstinence symptoms. Opioid treatment is limited by toxic side effects, and the problem can be solved by changing the opioid. The author describes three cases to illustrate these problems.