What antidote should be prepared for a suspected acetaminophen overdose?

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Acetylcysteine is the antidote specifically indicated for acetaminophen overdose. It works by replenishing glutathione levels in the liver, which helps to convert the toxic metabolite of acetaminophen (NAPQI) into a non-toxic form, thereby preventing liver damage. Acetylcysteine is most effective when administered within 8 to 10 hours after an overdose, but can still provide benefits even if given later.

Activated charcoal, while sometimes utilized in the case of overdose to absorb the drug and reduce systemic absorption, does not specifically counteract the toxic effects of acetaminophen. Flumazenil is used for benzodiazepine overdoses and is not relevant in this context. Atropine is used in cases of organophosphate toxicity and bradycardia, but it does not have a role in treating acetaminophen overdose. Hence, acetylcysteine stands out as the key agent for mitigating the effects of acetaminophen toxicity.

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