Pharmacodynamics<unk>  serves as a prodrug to L-cysteine, a precursor to the biologic antioxidant glutathione. Hence administration of<unk>  replenishes glutathione stores. * Glutathione, along with oxidized glutathione (GSSG) and S-nitrosoglutathione (GSNO), have been found to bind to the glutamate recognition site of the NMDA and AMPA receptors (via their γ-glutamyl moieties), and may be endogenous neuromodulators. At millimolar concentrations, they may also modulate the redox state of the NMDA receptor complex. In addition, glutathione has been found to bind to and activate ionotropic receptors that are different from any other excitatory amino acid receptor, and which may constitute glutathione receptors, potentially making it a neurotransmitter. As such, since N-acetylcysteine is a prodrug of glutathione, it may modulate all of the aforementioned receptors as well. * Glutathione also modulates the NMDA receptor by acting at the redox site. L-cysteine also serves as a precursor to cystine, which in turn serves as a substrate for the cystine-glutamate antiporter on astrocytes; hence there is increasing glutamate release into the extracellular space. This glutamate in turn acts on mGluR2/3 receptors, and at higher doses of<unk> , mGluR5.<unk>  also possesses some anti-inflammatory effects possibly via inhibiting NF-κB and modulating cytokine synthesis. Pharmacokinetics<unk>  is extensively liver metabolized, CYP450 minimal, urine excretion is 22-30% with a half-life of 5.6 hours in adults and 11 hours in neonates.
Acetylcysteine
Fomepizole
Sodium bicarbonate
Disufenton sodium
Malaoxon
Sodium thiosulfate 
Physostigmine
Cyanocobalamin