2. the high peak plasma concentration that results from the rapid initial infusion of acetylcysteine for paracetamol poisoning produces nausea in about 40% of patients and anaphylactoid reactions in about 20%. Although these reactions are routine and normally easily treated, it is important to reduce the rate of such reactions in study participants. The revised regimen provides a similar amount of acetylcysteine but administers it more evenly across 7 hours, producing a lower peak acetylcysteine concentration and a lower likelihood of nausea and anaphylactoid reactions (Dr R Thanacoody, unpublished).