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. Liver injury induced by paracetamol and challenges associated with intentional and unintentional use The Case Severe high anion gap metabolic acidosis Kidney International TYLENOL [Acetaminophen] metabolism A lot of GLUTATHIONE is needed to deal with the Oxidative Stress generated by the CYP 450 metabolism of Tylenol. When people go to the ER for Tylenol Overdose A study published in Gastroenterology describes a new mitochondrial mediator in the hepatotoxicity induced by paracetamol. Institute of Biomedical Research of Barcelona Pyroglutamic acidosis Deranged Physiology