A 48 hour fast can turn standard Paracetamol into acute liver failure. Fasting depletes Glutathione, leaving the liver defenseless against toxic NAPQI. Review the latest guidelines on BMJ Best Practice: https: bestpractice.bmj.com topics en us 1010 The Case Severe high anion gap metabolic acidosis Kidney International Correct Answer: B. N acetylcysteine (NAC) Why is this High Yield? Acetaminophen (Paracetamol) is widely used, making toxicity a common ER presentation. 1. Mechanism of Toxicity: Acetaminophen is metabolized in the liver. Sulfate conjugation may be the key to hepatotoxicity in paracetamol overdose Li 2021 British Journal of Clinical Pharmacology Wiley Online Library Acetaminophen metabolism
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paracetamol and glutathione depletion g-glutamyl cycle. Depletion of glutathione by acetaminophen leads to