N-Acetylcysteine: Beyond Paracetamol Overdose
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I asked David Aiello, President BioAdvantex Pharma Inc.: of all the molecules, why study and productise N-acetylcysteine? “That makes me think of another question, why did you marry that woman? You become fascinated with something, and your mind sees forward. I saw this as a huge business and scientific project with such a broad scope to help people. We didn't even understand the scope way back then.” Paracetamol-induced acute liver failure. In the US and UK, paracetamol (acetaminophen) toxicity is the most common cause of acute liver failure. When taken in normal therapeutic doses, paracetamol is safe. The cytochrome P450 enzymes convert approximately 5% of paracetamol to a highly reactive intermediary metabolite, N-acetyl-p-benzoquinoneimine (NAPQI). Under normal conditions, NAPQI is detoxified by conjugation with glutathione. In cases of overdose, the pathways become saturated, leading to more NAPQI. Liver supplies of glutathione become depleted, and NAPQI remains in its toxic form in the liver, reacting…