N-Acetyl Cysteine (NAC) Therapy Mechanism of Action: The non-toxic route of APAP metabolism gets saturated in overdoses, which leads to the formation of the toxic metabolite NAPQI. NAC helps replenish glutathione stores to conjugate the toxic metabolite, and assists with other routes of liver metabolism as well. See Figure 2 below. Figure 2.1 NAC has a hepatoprotective effect. NAC augments sulfation, NAC2 is a glutathione (GSH) precursor, NAC3 is a GSH substitute, and NAC4 improves multiorgan function during hepatic failure and possibly limits the extent of hepatocyte injury. #Pathophys #Toxicology #NAC #APAP #NAcetylCysteine #Acetaminophen #Toxicity #emDocs
