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The Cleveland clinic foundation

The hepatotoxicity of APAP rests predominantly with the highly toxic and reactive compound NAPQI, which forms covalent bonds with sulfhydryl groups on cysteine and lysine molecules within the mitochondria of hepatocytes and which spontaneously reacts with GSH and binds to hepatic proteins.8,11 The protein adducts formed, specifically those of mitochondrial protein adducts, lead to oxidative injury and hepatocellular necrosis

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It is possible that children with lower baseline glutathione levels, may need a higher dose or a longer intervention to attain similar behavioral outcomes

doi: 10.1200/JCO.2004.10.105

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