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 Multiscale modelling approach combining a kinetic model of glutathione metabolism with PBPK models of paracetamol and the potential glutathione depletion biomarkers ophthalmic acid and 5 oxoproline in humans and rats Integrative Biology (RSC Refractory high anion gap metabolic acidosis due to chronic paracetamol use: a case report Journal of Medical Case Reports Springer Nature Link Pharmacology 401 k Paracetamol NAPQI Glutathione COX3 Poisoning Antidote AcetylCysteine
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