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However, when phase II metabolizing enzymes are saturated after APAP overdose, excessive NAPQI deplete GSH, leading to covalent binding of sulfhydryl groups in cellular proteins, especially mitochondrial proteins [95]
Once initiated, the lipid radicals react with oxygen to form lipid peroxyl radicals, which are even more reactive (60)
The approach differs significantly between deficiency with and without neurological involvement
One unanswered question is whether long-term use could lead to reduced responsiveness over time
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