Table 9. [Emergency Outpatient Treatment in Individuals with MADD]. - GeneReviews®

Manifestation/Concern	Treatment	Consideration/Other
Metabolic decompensation/ hypoglycemia ¹	Decrease fasting interval by 50% of non-sick-day duration.	See Table 8 for recommended maximal fasting intervals at baseline.
Fever	Administration of antipyretics (acetaminophen, ibuprofen) if temperatures rises >38.5°C	If ↓ PO intake, vomiting, or lethargy: start emergency inpatient treatment (see Table 10). There should be low threshold for starting inpatient management for infants & young children.
Occasional vomiting	Antiemetics	Some classes of antiemetics can be used safely on an occasional basis to temporarily improve enteral tolerance of food & beverages at home or w/transfer to hospital.

Manifestation/Concern

Treatment

Consideration/Other

Metabolic
decompensation/
hypoglycemia ¹

Decrease fasting interval by 50% of non-sick-day duration.

See Table 8 for recommended maximal fasting intervals at baseline.

Fever

Administration of antipyretics (acetaminophen, ibuprofen) if temperatures rises >38.5°C

If ↓ PO intake, vomiting, or lethargy: start emergency inpatient treatment (see Table 10).
There should be low threshold for starting inpatient management for infants & young children.

Occasional vomiting

Antiemetics

Some classes of antiemetics can be used safely on an occasional basis to temporarily improve enteral tolerance of food & beverages at home or w/transfer to hospital.

From: Multiple Acyl-CoA Dehydrogenase Deficiency

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