Acetylcysteine

Acetylcysteine is a medication used to loosen thick mucus and treat acetaminophen overdose. It supplies cysteine for glutathione production, helping limit liver injury.

Glutathione: Glutathione is a tripeptide antioxidant that helps cells neutralize reactive compounds and maintain redox balance. Acetylcysteine supplies cysteine, a building block cells use to synthesize glutathione.
Acetaminophen poisoning: Acetaminophen poisoning is injury from excessive acetaminophen exposure, which can cause severe liver damage. Acetylcysteine is the principal antidote used to reduce liver injury after overdose.
Fomepizole: Fomepizole is an antidote that blocks alcohol dehydrogenase in methanol and ethylene glycol poisoning. Unlike acetylcysteine for acetaminophen poisoning, it targets toxic alcohol metabolism.
Acute liver failure: Acute liver failure is rapid loss of liver function in someone without established cirrhosis. Prompt acetylcysteine treatment can prevent acetaminophen poisoning from progressing to this emergency.
Cysteine: Cysteine is a sulfur-containing amino acid used to build proteins and molecules including glutathione. Its availability links acetylcysteine metabolism to glutathione replenishment.
Rumack–Matthew nomogram: The Rumack–Matthew nomogram estimates hepatotoxicity risk from a timed blood acetaminophen concentration after a single acute ingestion. Its risk assessment helps determine whether acetylcysteine treatment is indicated.
Naloxone: Naloxone is an opioid receptor antagonist used to reverse opioid overdose. It treats a different poisoning mechanism and does not replenish glutathione.
Anaphylactoid reaction: An anaphylactoid reaction is an acute systemic reaction resembling anaphylaxis but not requiring prior sensitization. Intravenous acetylcysteine can cause flushing, wheezing, or hypotension through this type of reaction.
Disulfide bond: A disulfide bond is a covalent link between sulfur atoms in two cysteine residues. Acetylcysteine can reduce disulfide bonds that help give mucus its viscosity.
Intravenous therapy: Intravenous therapy delivers fluids or medications directly into a vein. This route is used for acetylcysteine when rapid treatment or oral dosing is unsuitable.

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ToxicologyBroader topic: It is a standard example of mechanism-informed treatment for a drug overdose.