The mechanism of paracetamol-induced hepatotoxicity: implications for therapy.
1 The reactive metabolite responsible for paracetamol-induced hepatotoxicity, postulated to be N-acetyl-p-benzoquinoneimine reacts with N-acetyl cysteine. 2 An adduct is formed by an SN2 mechanism and paracetamol is produced by a redox reaction. 3 The adduct produced is capable of further oxidation by N-acetyl-p-benzoquinoneimine. 4 Methionine does not react with the reactive metabolite to any great extent.
D000082:Acetaminophen / Q000378:metabolism / Q000506:poisoning*; D000931:Antidotes / Q000627:therapeutic use*; D016227:Benzoquinones; D001711:Biotransformation; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D007097:Imines / Q000378:metabolism / Q000633:toxicity; D008658:Inactivation, Metabolic; D010084:Oxidation-Reduction
D000931:Antidotes; D016227:Benzoquinones; D007097:Imines; D000082:Acetaminophen; C028473:N-acetyl-4-benzoquinoneimine