Laboratory results and are presented and examined. Here we report a rare case of iatrogenic NAC overdose following an error in preparation of the solution, and describe its clinical symptoms. All healthcare practitioners involved in the medication-use process should be notified about the potential for confusion between this name pair, as the name confusion may occur anywhere in the prescription ordering process from illegible handwriting, to order transcription, to incorrect product selection during computer order entry, and finally to product selection in the pharmacy.Ghafar Ali Mahmoudi, 1 Peyman Astaraki, 1 Azita Zafar Mohtashami, 1 Maryam Ahadi 2ġFaculty of Medicine, Department of Internal Medicine, Lorestan University of Medical Sciences, 2Legal Medicine Research Center of Lorestan, Khorramabad, IranĪbstract: N-acetylcysteine (NAC) is used widely and effectively in oral and intravenous forms as a specific antidote for acetaminophen poisoning. Since all of the name confusion to date has occurred in an inpatient setting, pharmacists, nurses, and physicians should be made aware of the potential for confusion between Mucomyst and Mucinex. Since the benefit of Mucomyst has not been established for this indication, it is difficult to determine the resultant risk if the patient is not administered the intended drug. In this latter scenario, when Mucomyst is prescribed for the aforementioned off-label indication, the assumption is that Mucomyst may provide some nephroprotective effect from exposure to contrast dye.
Antidote for tylenol overdose mucomyst skin#
Conversely, where patients receive Mucinex instead of the intended Mucomyst, they may experience the same symptoms, plus GI discomfort, dizziness, headache, skin rash, and urticaria. In cases where patients receive Mucomyst instead of the intended Mucinex, they may experience some GI symptoms such as nausea or vomiting. Additionally, with regard to Mucinex, direct-to-consumer advertising has recently increased, thereby potentially leading to name recognition and increased inpatient prescribing. Healthcare practitioners may not be familiar with the off-label indication of Mucomyst. Unfamiliarity with the name Mucinex and its use in an inpatient setting may have contributed to these errors. In several of these cases the reporter noted that the first three letters of the desired drug name "Muc" were typed in the computer, but the wrong drug name was selected inadvertently from the list of drug names. When Mucomyst is used for the aforementioned off-label indication, both Mucinex and Mucomyst have suggested doses of 600 or 1200 mg, administered orally twice daily.Ĭomputer selection errors have also been noted. Compounding the potential for confusion between Mucomyst and Mucinex are the dose and dosing-interval commonalities. Phonetically, both names contain three syllables with an identical beginning (muc), which contributes to the sound-alike characteristics. Although the ending letters of Mucomyst and Mucinex are relatively different, the ending of each name may not be distinguishable if it is not written clearly on an order. The look-and sound-alike similarity between the drug names Mucomyst and Mucinex is due to the identical three-letter beginning of each name. The suggested dose for this off-label use is 600 or 1200 mg given orally twice daily the day before and on the day of the administration of contrast media, for a total of four doses. However, several articles have been published suggesting that Mucomyst may have benefit in the prevention of acute renal failure associated with radiographic contrast media. Mucomyst (acetylcysteine) is an inhalational mucolytic agent approved as adjuvant therapy for abnormal, viscid, or inspissated mucus secretions, and for oral use as an antidote to prevent or lessen hepatotoxicity following acute acetaminophen overdose. No adverse events were reported as a result of these errors.
To date, all errors reported to the FDA MedWatch system occurred during the prescription order, transcription, and product selection phases of inpatient medication use.
These errors may be occurring due to the increased off-label use of Mucomyst for the prevention of acute renal failure associated with radiographic contrast media. The FDA wants to alert healthcare providers about name confusion between Mucomyst and Mucinex.
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