Rectal enema OR via distal intestinal stoma

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Rectal enema OR via distal intestinal stoma

40–200 mg/dose of acetylcysteine 4% (1–5 mL of acetylcysteine 4%) 6–8 hourly. Acetylcysteine 4% = 40 mg/mL

50–100 mg/dose of acetylcysteine 1% (5–10 mL/kg of acetylcysteine 1%) 6–8 hourly has also been reported. Acetylcysteine 1% = 10 mg/mL

Dose adjustments – special scenarios	No information.
Maximum dose	400 mg/dose orally
Total cumulative dose
Route	Oral via gastric tube Rectal Distal intestinal stoma or via T-tube ileostomy Irrigation through Replogle tube
Preparation	Intragastric preparation^4,5 Acetylcysteine 10%: Dilute 5 mL of acetylcysteine 20% (200 mg/mL) with 5 mL of glucose 5% or sodium chloride 0.9%* to make a final volume of 10 mL with a concentration of acetylcysteine 10% (100 mg/mL) For Acetadote Concentrated Injection – use glucose 5% only Rectal or stoma administration^22,23 Acetylcysteine 4%: Dilute 1 mL of acetylcysteine 20% (200 mg/mL) with 4 mL of glucose 5% or sodium chloride 0.9% to make a final volume of 5 mL with a concentration of acetylcysteine 4% (40 mg/mL) *For Acetadote Concentrated Injection – use glucose 5% only.
Administration	Intragastric/rectal/stoma: Administer slowly Irrigation via Replogle tube: As a continuous irrigation with suction applied
Monitoring	Cardiorespiratory, serum electrolytes, liver function

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