NBME 16 Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite (NBME Answers)

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A 20-year-old man is brought to the physician ...
Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite 🔍 / 📺 / 🌳 / 📖
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submitted by ∗hungrybox(1277)

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ACUTE alcohol inhibits CYP → Increased bioavailability of acetominophen

CHRONIC alcohol induces CYP → Induction of cytochrome P450 enzymes that activate acetaminophen to a hepatotoxic metabolite

I got this wrong because I assumed chronic alcohol meant years and years. I guess a weekend will suffice?

Honestly, fuck this problem.

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lfcdave182 Yeah fuck this question. 2-3 days of something would never be considered chronic in anything else. +6

pontiacfever Drink a lot for a week makes you a chronic alcoholic? +1

pontiacfever That means alcohol abuse = chronic alcoholism +2

skilledboyb Why would increased bioavailability of acetaminophen place the patient at increased risk of liver injury? What's dangerous about that? +

i_hate_it_here Metabolism of acetaminophen turns it into toxic metabolites (NAPQI) that inhibit glutathione in the liver forming toxic tissue products. FA2020 pg: 485 +3

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submitted by ∗feliperamirez(45)

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Acetaminophen is mainly glucuronidated and minimally metabolized to NAPQI by CYP 450 enzymes

Chronic alcohol consumption induces CYP 450, so more acetaminophen is metabolized to NAPQI

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detayo Would this qualify as chronic alcohol though? +12

detayo Would this qualify as chronic alcohol though? +

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