#paracetamol
Sun, 05 Apr 2015 23:09:35
What are y'all allergic to I’m really curious
Normal metabolism
- Drug metabolizing enzymes are are located in lipophilic membranes of endoplasmic reticulum (Cytochrome P450 (2E1, 1A2 and 3A4))
- 95% of paracetamol is conjugated with glucaronic acid or sulphate and excreted in urine. This is non-toxic.
- 5% is oxidized by the CYPs to form N-acetyl-P-benzoquinone imine (NAPQI), which is toxic.
- NAPQI is conjugated with glutathione and mercapturic acid and cysteine conjugates and excreted in bile in normal metabolism.
In overdose
- the glucaronic acid and sulphate pathways become saturated, so more goes via the NAPQI pathway.
- Glutathione stores become depleted as it is consumed by the NAPQI.
- NAPQI accumulates and begins conjugating hepatic proteins and nucleic acids, including those of the mitochondria.
- Enzymes such as glutathione peroxidase, HMG-CoA, become inhibitedandradicals begin forming as the mitochondria are damaged.
- In the cytosol, MAP kinase JNK is activated, which binds to Sab proteins on the outer mitochondrial membrane, which in turn deactivates p-Src on the inner mitochondrial membrane.
- This inhibits electron transport.
- Moreradicalsare released and there is more oxidative stress.
- There is mitochondrial and cell death leading to necrosis if not treated early enough.
Liver function tests:
- GGT elevated
- Bilirubin elevated
- ALP elevated
- AST and ALT extremely high
- Becoming higher than 100 times the upper reference limit in toxic ingestion. No other hepatic conditions increase AST/ALT to these levels.
- Decreased albumin once necrosis forms – many other conditions of the liver don’t reach this stage
Aries: pen to stab a bitch who talking shit
Taurus: fuckboy repellent
Gemini: earphones
Cancer: triplus 30 pack fine liners to make the hoes jealous
Leo: phone charger
Virgo: paracetamol
Libra: ruler to smack a bitch
Scorpio: gum
Sagittarius: water to fulfil them thirsty hoes
Capricorn: coloured pencils for cheeky doodles
Aquarius: scissors to cut an annoying bitch
Pisces: pillow
i’m currently high but not on morphine. my high aesthetic ⏳