Carbon tetrachloride (CCl4) is metabolized by the cytochrome P450 system with generation of toxic free radicals. Management of a patient should be directed towards reducing formation and enhancing elimination of these products.
Management may include:
(1) hyperbaric oxygen
(2) administration of N-acetylcysteine or glutathione
(3) dialysis if there is renal failure
(4) supportive therapy for other toxicities
Hyperbaric oxygen inhibits cytochrome P450 (thereby reducing formation of CCl3) and promotes conversion of CCl3 to less toxic compounds.
Both acetylcysteine and glutathione are derivatives of cysteine. The sulfhydryl group serves as a proton donor which helps to inactive free radicals.
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