An Example of a Drug That Causes Toxicity Through the Formation of a Chemically Reactive Intermediate Mechanisms of Adverse Drug Reactions Pharmacovigilance 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 Biotransformation, Elimination and Bile Acid Metabolism Abdominal Key N Acetyl 4 benzoquinone imine (NAPQI, N Acetyl p benzoquinonimine, CAS Number: 50700 49 7) Cayman Chemical Acetaminophen metabolism and NAPQI mediated mitochondrial effects Download Scientific Diagram