Acetaminophen Induced Toxicity

Introduction

Acetaminophen (APAP) is an active ingredient in many over the counter painkillers, such as Tylenol and Oxycodone. APAP misuse is responsible for approximately 50% of acute liver failure cases in the United States (). Treatments for Acetaminophen Induced Liver Injury (AILI) are limited and ineffective if not caught early enough. Considering this and the widespread use of other prescription opioids, it is imperative that the mechanism of acetaminophen induced hepatotoxicity be revisited.

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Currently accepted two electron oxidation of acetaminophen pathway (click to enlarge). The pathway leading to NAPQI is shown in red.

The current accepted mechanism by which AILI presents itself is through a two electron oxidation.

References

Potter, David W., Dwight W. Miller, and Jack A. Hinson. Identification of Acetaminophen Polymerization Products Catalyzed by Horseradish Peroxidase. Journal of Biological Chemistry, 260,22 (1985). 12174-2180. Print