Antidotes

Chloroform is known to deplete glutathione stores and acetylcysteine has been suggested as a possible antidote for hepatotoxic organic solvents (Laurenzi et al., 1987). Glutathione precursors such as cysteine have been shown to provide protection against liver toxicity in animals. Cysteine may also act as a nucleophilic agent.

This is supported by the observation that cysteamine, which is not a glutathione precursor, is also protective (Docks and Krishna, 1976).

There is limited data on the use of acetylcysteine in chloroform poisoning. However, it is relatively safe and easily available and should be considered for chloroform poisoning to minimise hepatic damage. Acetylcysteine has been used with success in patients with carbon tetrachloride poisoning. The regimen is the same as that for paracetamol poisoning but a longer duration of therapy is recommended (Ruprah et al., 1985). An adult who ingested 230 ml of chloroform survived with minimal hepatic damage after treatment with acetylcysteine for 4 days (Boyer et al., 1998).

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