What is the antidote for an acetaminophen overdose?

N-acetylcysteine is recognized as the specific antidote for acetaminophen overdose due to its ability to replenish glutathione reserves in the liver. Acetaminophen is metabolized in the liver, where a portion is converted to a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI). In normal circumstances, this toxic compound is neutralized by binding to glutathione. However, during an overdose, the liver’s glutathione supply is depleted, leading to potential liver damage.

By administering N-acetylcysteine, it acts as a precursor for the synthesis of glutathione, effectively preventing or mitigating liver injury caused by excessive levels of acetaminophen. It's most effective when given within 8-10 hours of ingestion, but can still provide benefits later, making it a critical treatment in acetaminophen poisoning situations.

Other options, while they can serve various roles in medical emergencies, do not specifically counteract the effects of acetaminophen toxicity. For instance, activated charcoal may help reduce the absorption of acetaminophen if administered within a certain time frame after ingestion, but it does not address the toxic effects after absorption. Flumazenil is a benzodiazep