Haggling with HAGMA: A Common Medication with an Uncommon Differential Renal Fellow Network Acute acetaminophen paracetamol toxicity Two chromatographic methods for analyzing paracetamol in spiked human plasma with its toxic metabolite, N acetyl parabenzoquinone imine and its antidote, N acetyl l cysteine Scientific Reports 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 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