Which medication should be accompanied by N-acetylcysteine in cases of overdose?

N-acetylcysteine is a specific antidote used primarily in cases of acetaminophen (commonly known as paracetamol) overdose. Acetaminophen can lead to severe hepatic (liver) damage, especially when taken in doses that exceed recommended levels. The mechanism of injury involves the depletion of glutathione, a protective antioxidant in the liver, leading to the accumulation of toxic metabolites. N-acetylcysteine serves as a precursor for glutathione and helps to replenish its levels, thereby mitigating liver damage and preventing further toxicity when administered within a specific time frame after the overdose.

The timing of N-acetylcysteine administration is critical, as it is most effective when given within 8-10 hours following acetaminophen ingestion. Beyond this timeframe, the benefits of treatment begin to diminish, although it can still be given later in some cases.

Other medications listed do not have this specific association with N-acetylcysteine. For instance, ibuprofen and salicylic acid (a type of aspirin) have different mechanisms of toxicity and management protocols in an overdose situation. Codeine is an opioid and would require different methods of management in overdose cases, typically involving opioid receptor antagonists