N Acetylcysteine Mechanism Of Action In Acetaminophen Toxicity

Indicating that virtually all n acetylcysteine acetaminophen originated from the metabolism of the glutathione acetaminophen adduct rather than from a direct reaction with the toxic metabolite.

N acetylcysteine mechanism of action in acetaminophen toxicity. Although no acetaminophen is detectable in his blood his serum alanine aminotransferase concentration is 750 iu per liter and treatment with acetylcysteine is recommended. Nac has several mechanisms of action that are beneficial in the treatment of acetaminophen poisoning which include serving as a glutathione replacement and a free radical scavenger binding napqi directly and increasing microcirculatory oxygenation 16. N acetylcysteine should be used in all cases of early acetaminophen poisoning where the plasma acetaminophen concentration lies above the line which line is chosen depends on individual preference and whether enzyme induction is suspected. Hinson effect of n acetylcysteine on acetaminophen toxicity in mice.

Efficacy of oral n acetylcysteine in the treatment of acetaminophen overdose. N engl j med. When given early after apap ingestion nac s main mechanism of action is to maintain intracellular glutathione stores so to detoxify the electrophilic apap metabolite napqi. Analysis of the national multicenter study 1976 to 1985.

Nac is generally well tolerated when given intravenously with the main concern being anaphylactoid reactions. N acetylcysteine inhibited the o deethylation of ethoxyresorufin cytochrome p 448 while methionine enhanced the n demethylation of benzphetamine cytochrome p 450 and increased hepatic microsomal levels of cytochrome p 450. N acetylcysteine promptly reversed the acetaminophen induced depletion of glutathione by increasing glutathione. In the treatment of acetaminophen overdose acetylcysteine acts to maintain or replenish depleted glutathione reserves in the liver and enhance non toxic metabolism of acetaminophen.

Relationship to reactive nitrogen and cytokine formation toxicological sciences volume 75 issue 2 october 2003. The mechanism of the protective action of methionine and n acetylcysteine against the toxicity of paracetamol was investigated in vivo.