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While the goal is to treat patients before the development of acute liver failure, treatment should still be given to patients who are found to be in active hepatic failure since NAC appears to improve hepatic perfusion and oxygen delivery, to refine mitochondrial energy metabolism, and to facilitate scavenging of reactive oxygen and nitrogen species

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A small number of ifosfamidetreated patients (up to 30%) develop acute encephalopathy within hours or days after administration, with dyskinesia, extrapyramidal syndromes, ataxia, myoclonus, and complex partial status epilepticus observed [165], mainly through mitochondrial toxicity and oxidative stress [166]

Relationship between homocysteine and coronary artery disease

The timing of the glutathione push is important because glutathione is unstable when mixed in IV bags with vitamin C and degrades over time in saline solutions