What is the primary antidote for treatment of acetaminophen poisoning?

• A. Librium
• B. Deferoxamine
• C. N-acetylcysteine
• D. Digiband

Answer: (C)

N-acetylcysteine is the primary antidote for acetaminophen poisoning due to its ability to restore depleted levels of glutathione, a crucial antioxidant in the liver. Acetaminophen is metabolized in the liver, where it can form a toxic metabolite that, when present in large quantities due to overdose, can cause significant liver damage. N-acetylcysteine acts by providing sulfhydryl groups that help to conjugate the toxic metabolite, ultimately allowing it to be safely excreted from the body.

This treatment is especially effective when administered within a specific time frame after ingestion, ideally within 8 to 10 hours, but it can still be beneficial if given later. The mechanism of action also serves to mitigate the hepatic damage by promoting the synthesis of glutathione, further enhancing the liver's ability to eliminate the toxic metabolite. This makes N-acetylcysteine a critical component of the management strategy in cases of acetaminophen toxicity, thus explaining its designation as the primary antidote.