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Probably due to the binding preference of APAP to the active site of each P450 isomer, it is oxidized via two pathways to form the toxic intermediate N-acetyl-p-benzoquinone imine (NAPQI) and the non-toxic catechol metabolite 3-hydroxy-APAP (3-OH-APAP) (Figure 1)

Overexpression of glutathione S-transferase and elevation of thiol pools in a multidrug-resistant human colon cancer cell line Mol Pharmacol 1992 41 : 6975 Smith MT, Evans CG, Doane-Setzer P, Castro VM, Tahir MK, Mannervik B

10.3389/fphar.2022.897791 56 LeeH

Spinal decompression surgery with fusion is the standard option, although spinal fusion limits mobility at the fused segment