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Next, glycine is added to \(\gamma\)-glutamylcysteine to generate \(\gamma\)-glutamyl-cysteinyl-glycine or GSH, and this second step is catalyzed by glutathione synthase 33
High-dose CTX may cause pericardial effusions, pericardial tamponade, CHF, and acute hemorrhagic myopericarditis with myocardial thickening (caused by intramyocardial extravasation of blood, fibrin, or fibrin-platelet microthrombi in capillaries, and fibrin strands in interstitiumsee Figure 2) and progressive ventricular dysfunction (90, 91)
All options should be on the table, but there are significant ethical concerns with initiating medication for addiction that might not be there for long term, said Leo Beletsky, a professor of law and health sciences at Northeastern University in Boston
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