USMLE Step 2 CK Question of the Day: Altered Mental State After Over the counter pain reliever and Prescription Hydrocodone acetaminophen Osmosis Blog Acetaminophen MSK Medbullets Step 1 Acetaminophen at low doses depletes airway glutathione and alters respiratory reflex responses Smith 2013 The FASEB Journal Wiley Online Library Since Tylenol is such a hot topic right now, did you know it depletes glutathione levels? When your body processes Tylenol in the liver, one of the pathways creates a toxic byproduct. To neutralize GSH reduces NAPQI, the metabolite responsible for hepatotoxicity in acetaminophen toxicity. Toxic doses increase oxidation into NAPQI, overwhelming glutathione. How does ethanol interfere with acetaminophen metabolism? Image: https: t.co 6EY9dIwLXY Paracetamol (Acetaminophen) and the Developing Brain