![]() The mobile phase included ammonium formate buffer (pH 3.0, 5 mM) and acetonitrile (15:85, v/v) with the flow rate set at 0.500 mL/min. A Waters XBridge C18 column (3.5 micron, 4.6 x 150 mm) was used for separation of ondansetron. A liquid chromatography mass spectrometry (LC – MS/MS) method was able to quantify levels of ondansetron. A UV wavelength of 212 nm was utilized for detection of NAC. The flow rate was set at 0.500 mL/min with an injection volume of 10 microliters and a temperature of 50 oC. The analysis was conducted on an Agilent Eclpise XDB-C18 column (3.5 micron, 4.6 x 150 mm) with a mobile phase containing acetonitrile (ACN), water (10:90 v/v), and 0.1 % trifluoroacetic acid (TFA). A reverse phase high-performance liquid chromatography (RP-HPLC) method was utilized for NAC quantification. This causes treatment interruption in a medical emergency therefore, we are investigating the IV compatibility of NAC and ondansetron to reduce the steps in treating acute nausea/vomiting. Another IV flushing follows before NAC is resumed. Inconveniently, the NAC 21-hour intravenous (IV) infusion needs to be halted with IV flushing before ondansetron can be administered. Often, nausea and vomiting are associated with NAC use and is treated acutely by ondansetron (Zofran), a 5-HT3 receptor antagonist. This is worrisome due to the risk of hepatoxicity, especially in children and adolescents. N-acetylcysteine (NAC) is the antidote for acetaminophen (Tylenol) toxicity from over ingestion leading to 56,000 emergency room visits yearly. Liver damage and the resulting scarring may compromise long-term liver function in cats who recover from acetaminophen toxicity.Introduction. ![]() The level of a compound called glutathione in the blood helps to assess the effectiveness of treatment. In addition, levels of serum liver enzymes are monitored in order to assess for liver damage. Once a cat is treated for acetaminophen toxicity, is there any follow-up that must be done?īlood levels of methemoglobin must be monitored. Vitamin C (ascorbic acid) reduces methemoglobin levels in the blood over time. A medicine called N-acetylcysteine (Mucomyst®) is considered to be an antidote for acetaminophen toxicity. The activated charcoal attracts the remaining molecules of acetaminophen and keeps them from being absorbed from the gastrointestinal tract. “A medicine called N-acetylcysteine (Mucomyst®)Īctivated charcoal may be administered immediately after vomiting has been induced or after the stomach has been flushed, once vomiting is controlled. ![]() In addition, intravenous fluid therapy is delivered to maintain proper hydration and electrolyte balance. ![]() A low red blood cell count, called “anemia”, blood in the urine, called “hematuria”, or the presence of hemoglobin in the urine, called “hemoglobinuria”, may require transfusion of whole blood. This is only useful within 4–6 hours of acetaminophen ingestion. These cats need very gentle handling, as they are often fragile.ĭepending upon the timing of the acetaminophen ingestion, your veterinarian may induce vomiting, and may perform flushing of the stomach. Likewise, dark or bloody urine, or yellowish discoloration of the skin or mucus membranes (jaundice) demands inpatient care. The presence of methemoglobin in the blood demands a prompt diagnosis, hospitalization, and aggressive care. Is there any treatment for a cat who is experiencing acetaminophen toxicity? Death as a result of methemoglobinemia occurs 18–36 hours after ingestion. Occasionally, the first sign of acetaminophen toxicity is death. The urine may become dark or even chocolate-colored from the presence of blood or methemoglobin. ![]() Some cats will develop fluid buildup in the face, paws, and forelimbs several hours after ingesting acetaminophen. ![]()
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