acetaminophen_nomogram: Acetaminophen Overdose NAC Dosing (Rumack-Matthew Nomogram)

In cliot: Clinical Indices and Outcomes Tools

Acetaminophen Overdose NAC Dosing (Rumack-Matthew Nomogram)

Description

Determines the need for N-acetylcysteine (NAC) treatment following a single acute acetaminophen ingestion. The function utilizes the Rumack-Matthew Nomogram logic, specifically the "Treatment Line" (starting at 150 mcg/mL at 4 hours), to interpret serum acetaminophen levels obtained between 4 and 24 hours post-ingestion.

Usage

acetaminophen_nomogram(time_ingestion_hrs, acetaminophen_level, units = "mcg/mL")

Arguments

time_ingestion_hrs	Numeric. Time passed since the ingestion in hours. The nomogram is valid only for single acute ingestions between 4 and 24 hours.
acetaminophen_level	Numeric. The measured serum acetaminophen concentration.
units	String. Units of the concentration measurement. Options: "mcg/mL" (default) "mg/L" "mg/dL" "micromol/L"

Value

A list containing:

Standardized_Level_mcg_mL	The input level converted to mcg/mL.
Treatment_Threshold_mcg_mL	The nomogram threshold value for the specific time provided.
Recommendation	Clinical guidance based on whether the level falls above or below the treatment line.

References

Rumack BH, Matthew H. Acetaminophen poisoning and toxicity. Pediatrics. 1975;55(6):871-876.

Examples

# Example 1: Treatment Needed
# 8 hours post-ingestion, Level 100 mcg/mL
# Threshold at 8 hours is 75 mcg/mL -> Above line
acetaminophen_nomogram(8, 100, "mcg/mL")

# Example 2: No Treatment
# 5 hours post-ingestion, Level 100 mcg/mL
# Threshold at 5 hours is ~126 mcg/mL -> Below line
acetaminophen_nomogram(5, 100, "mcg/mL")

# Example 3: Different Units
# 4 hours post, Level 20 mg/dL -> Converts to 200 mcg/mL (Above 150 threshold)
acetaminophen_nomogram(4, 20, "mg/dL")

cliot documentation built on Dec. 1, 2025, 1:06 a.m.