Question

How does an overdose of paracetamol affect the liver? (please include academic references used to answer this question)

Answer 1

Paracetamol is a drug used to control body temperature. 55% of the orally taken dose undergoes glucuronide conjugation and 35% undergoes conjugation with sulfate.

Metabolism of paracetamol generates NAPQI (N-acetyl parabezoquinoneimine), which is toxic to the liver. This toxic metabolite is detoxified by glutathione conjugation. During paracetamol toxicity, the glutathion availability become saturated. So, the excessive NAPQI causes liver damage by binding to liver proteins that causes centrilobular hepatic necrosis.