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Medicine G.I.T. 255f980c

A 24-year-old man with a history of depression is brought to the emergency room because of a drug overdose. He is experiencing some nausea and vomiting, but no other symptoms. Physical examination and vital signs are normal. Six hours prior to presentation, he intentionally took 40 tablets of acetaminophen (500 mg/tablet). Which of the following is the most appropriate next step in management?

A
give ethanol to compete with the parent drug for metabolism, therefore preventing formation of toxic metabolites
B
give Narcan to block its actions directly
C
give intravenous prostacyclin's to maintain cellular integrity
D
give N-acetylcysteine to allow binding of the toxic metabolite
High-Yield Explanation
N-acetylcysteine probably acts by providing a reservoir of sulfhydryl groups to bind the toxic metabolite of acetaminophen. Narcan is effective for narcotic overdose, and ethanol is the antidote for methanol intoxication.

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