<prompt> Treatment of paracetamol toxicity isAlkaline diuresisHemoperfiisionDialysisN - acetyl cysteine  <response>: Ans. is d i.e., N - acetyl cysteine Paracetamol poisoning It is a potent hepatic toxin. A small part is converted by a liver enzyme into N - acetyl-p-benzoquinoneimine. Glutathione and other sulphydryl compounds detoxify this substance, but in overdose NABP accumulates and causes severe centrilobular liver necrosis. Large doses act on brain stem and cause rapid death.Symptoms: Within a few hours - anorexia, nausea, vomiting, abdominal pain, diaphoresis, hypotension, tachycardia and dyspnoea. After one to two days, the discomfort disappears. After 2 to 4 days there is vomiting, jaundice, hepatic pain, bleeding, hypoglycaemia, confusion, coma, metabolic acidosis and coarse flapping tremor of hands asterixis. There may be cardiac arrhythmias, haemorrhagic pancreatitis, disseminated intravascular coagulation, etc. Death usually occurs in 3 to 4 days.Treatment:i Gastric lavage.ii Activated charcoal.iii N-acetylcysteine NAC is a specific antidote and has maximum efficacy if used within 8 hours. 