The Rumack–Matthew nomogram, also known as the acetaminophen nomogram, is an acetaminophen toxicity nomogram. It plots serum concentration of acetaminophen against the time since ingestion, in order to predict possible liver toxicity and allow a clinician to decide whether to proceed with N-Acetylcysteine (NAC) treatment.

Oct 8, 2021 · The Rumack nomogram may fail for a variety of reasons, so be careful when using it. IV acetylcysteine has been shown to improve mortality in patients with established liver failure. Even if the patient presents very late, they should still be treated with acetylcysteine.

Barry H. Rumack, MD, is currently director emeritus of the Rocky Mountain Poison and Drug Center and director, Office of Professionalism at UC Denver. He is a retired professor emeritus of pediatrics at the University of Colorado School of Medicine.

Nov 23, 2022 · More NAC means more glutathione, which means more capacity to detoxify the toxic metabolite of APAP, n-acetyl-para-benzoquinone imine (NAPQI). This modified nomogram gives theoretical recommendations for levels at which increased NAC doses may be considered.

In this calculator, mcg is the abbreviation for micrograms. This calculator is based on data from Rumack and Matthew 1. Treatment threshold levels are calculated to be 25% lower than the toxic drug level. This calculator is only appropriate for patients who had a single ingestion of acetaminophen.

Aug 1, 2018 · APAP overdose can be broadly divided into simple acute ingestion, wherein the evidence is strongest and the Rumack-Matthew nomogram is applicable, and cases with confounding factors, wherein expert opinion dictates practice. Epidemiology. Clinical Presentation. Key Point: The first stage of APAP toxicity is largely silent.

Jan 1, 2025 · The first nomogram is the standard Rumack-Matthew nomogram used since 1976 with the original 200 ug/mL line at 4 hours and the study design treatment line of 150 ug/mL at 4 hours. The second is the revised nomogram published in 2023 with the high risk 300 ug/mL line in addition to the standard treatment line at 150 ug/mL.

The Rumack-Matthew nomogram for acetaminophen toxicity (Figure 1), first published in 1975 and referred to as the “200 line,” was derived from acetaminophen levels from untreated patients; the “200 line” predicted outcome by dividing patients who did and who did not develop an aspartate aminotransferase level of 1,000 IU/L or greater in relation...

The Rumack-Matthew nomogram is an acetaminophen toxicity nomogram plotting serum concentration of acetaminophen against the time since ingestion in an attempt to prognosticate possible liver toxicity as well as allowing a clinician to decide whether to proceed with N-Acetylcysteine (NAC) treatment or not. It is a logarithmic graph starting not ...

Barry H. Rumack (born November 1, 1942) is an American medical toxicologist and pediatrician. His primary clinical and research interest has been in clinical toxicology with a special interest in acetaminophen poisoning.