Drug Metabolism · Pharmacology

In the metabolism of Acetaminophen (Paracetamol), which pathway becomes overloaded during an overdose, leading to hepatotoxicity?

  1. Hydrolysis by plasma esterases
  2. Acetylation by NAT2
  3. Oxidative deamination
  4. Glucuronidation and sulfation
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Correct answer: Glucuronidation and sulfation

At normal doses, Acetaminophen is mostly metabolized via glucuronidation and sulfation. In an overdose, these pathways saturate, forcing more drug through the CYP450 pathway to form the toxic metabolite NAPQI.

Difficulty: Medium Question 10 of 20

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