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description -acetylcysteine (also known as n-acetylcysteine or n-acetyl-l-cysteine or nac) is primarily used as a mucolytic agent and in the management of acetaminophen poisoning. it is a derivative of cysteine with an acetyl group attached to the amino group of cysteine. - -mechanism of action acetylcysteine protects against acetaminophen overdose-induced hepatotoxicity by maintaining or restoring hepatic concentrations of glutathione. it does this by producing the glutathione precursor l-cysteine. glutathione is required to inactivate an intermediate metabolite (n-acetyl-p-benzoquinoneimine or napqi) of acetaminophen that is thought to be hepatotoxic. in acetaminophen overdose cases excessive quantities of this metabolite are formed because the primary metabolic (glucuronide and sulfate conjugation) pathways become saturated. acetylcysteine may act by reducing the metabolite to the parent compound and/or by providing sulfhydryl for conjugation of the metabolite. experimental eviden