The SNAP regimen was implemented in 3 UK hospitals with the approval of their local medicines management committees with prospective audit of clinical outcomes. The Scottish and Newcastle Antiemetic Pre-treatment (SNAP) study has shown that a simpler 12 h regimen (SNAP) consisting of a reduced loading infusion rate of 50mg/kg/h, causes significantly fewer adverse reactions (1). Acetylcysteine (NAC) is the antidote of choice for treatment of paracetamol overdose, but the original 3-bag NAC regimen, designed in Edinburgh, is associated with infusion-related adverse reactions related to high peak plasma acetylcysteine concentrations from the high loading infusion of 600mg/kg/h. Paracetamol is the commonest drug involved in hospital admissions with poisoning in the UK.
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