Acetaminophen-related Hepatotoxicity

“…However, the present discovery seems to be consistent with other research results, which found massive hepatocyte necrosis, liver failure, or death in APAP intoxication (Bunchorntavakul and Reddy 2013).…”

“…Under conditions of excessive NAPQI formation or hepatic glutathione depletion, NAPQI covalently binds to vital proteins and the lipid bilayer of hepatocyte membranes. However, the present discovery seems to be consistent with other research results, which found massive hepatocyte necrosis, liver failure, or death in APAP intoxication (Bunchorntavakul and Reddy 2013 ).…”

“…These results were confirmed by other previous findings, the increase of survival rate, decrease of serum markers, and alleviation of liver histological damage in APAP-induced liver damage after the treatment of different plant extracts [62, 63]. Normally, clinical dose of APAP mainly binds to glucuronic acid or sulfate in the liver and then is excreted into plasma or bile [64, 65]. However, a small proportion of APAP administered at clinical dose can be rapidly metabolized by cytochrome P450 (CYP) system in liver and subsequently forms available reactive metabolite, N-acetyl-p-benzoquinone imine (NAPQI), combined with GSH and detoxified to innoxious mercaptoacetic acid in physiological conditions [66].…”

“…Notably, NAC therapy tended to be overutilized in our hospital, as 21 of 62 patients (34%) who had serum APAP concentration below the treatment line also received NAC. In addition, anaphylactoid reaction was observed in only 2/121 patients (1.7%) in this study, which appeared to be much lower than in previous literature (10–20%) 2…”