What is the specific pharmacological antidote for Acetaminophen (Paracetamol) hepatotoxicity?
Answer and explanation
Correct answer: C. N-acetylcysteine (NAC)
- Step 1: In Acetaminophen (Paracetamol) overdose, normal glucuronide and sulfate conjugation pathways become saturated, diverting metabolism through CYP2E1 to create the reactive hepatotoxic metabolite N-acetyl-p-benzoquinone imine (NAPQI).
- Step 2: Once hepatic glutathione stores are depleted below critical levels, NAPQI covalently binds to hepatocytes causing acute centrilobular necrosis. N-acetylcysteine (NAC) acts as a glutathione precursor and substitute that neutralizes NAPQI, protecting against fulminant liver failure.
Answer
N-acetylcysteine (NAC).
Why not the others: Atropine blocks muscarinic receptors in organophosphate toxicity, vitamin K reverses warfarin-induced coagulopathy, and deferoxamine chelates toxic iron overload.
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