What is the antidote for acetaminophen (Tylenol) poisoning?

Acetylcysteine is the antidote for acetaminophen (Tylenol) poisoning. It works by replenishing glutathione stores in the liver and helps to detoxify the harmful metabolites produced during the metabolism of acetaminophen. This is critical because acetaminophen can lead to severe liver damage when taken in overdose, as it depletes glutathione, which is essential for the safe processing of the drug in the liver.

Administering acetylcysteine promptly can prevent serious hepatic injury and improve outcomes for patients who present with acetaminophen overdose. It is most effective when given within 8 to 10 hours after ingestion but can still provide benefits even if administered later.

Other options like naloxone, activated charcoal, and flumazenil do not address the specific toxic mechanism of acetaminophen overdose. Naloxone is an opioid antagonist, activated charcoal is used to absorb various substances in the gastrointestinal tract, and flumazenil is a benzodiazepine antagonist. None of these alternatives target the metabolic pathway affected by acetaminophen, which is why acetylcysteine is the specific and effective choice for this scenario.