Acetaminophen metabolism. Acetaminophen is metabolized primarily by Download Scientific Diagram Full article: The acetaminophen metabolite N acetyl p benzoquinone imine ( NAPQI) inhibits glutathione synthetase in vitro; a clue to the mechanism of 5 oxoprolinuric acidosis? Paracetamol Induced Hepatotoxicity , Overdose NAPQI formation Glutathione depletion Liver cell necrosis. Early N acetylcysteine (NAC) can save the liver., #Pharmacology #mbbs #Hepatotoxicity GSH reduces NAPQI, the metabolite responsible for hepatotoxicity in acetaminophen toxicity. Toxic doses increase oxidation into NAPQI, overwhelming glutathione. How does ethanol interfere with acetaminophen metabolism? Image: https: t.co 6EY9dIwLXY Silymarin prevents acetaminophen induced hepatotoxicity via up regulation of the glutathione conjugation capacity in mice ScienceDirect