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8 The body requires a delicate balance between production and detoxification/transport of harmful reactive species and protein adducts, and when these defenses are overwhelmed at hepatotoxic doses of APAP, the glucoronidation and sulfonation pathways become saturated, pushing the majority of APAP to be metabolized to NAPQI by the CYP 2E1 pathway and resulting in GSH depletion and build-up of toxic NAPQI