A 48 hour fast can turn standard Paracetamol into acute liver failure. Fasting depletes Glutathione, leaving the liver defenseless against toxic NAPQI. Review the latest guidelines on BMJ Best Practice: https: bestpractice.bmj.com topics en us 1010 usmle #medstudent #medschool #medicalstudent #medicalstudent Manik Madaan, M.D. Acetaminophen Toxicity: How Genetic Susceptibility Combines with Environmental Factors Did you know that high doses of paracetamol can be toxic to your liver? Paracetamol, also known as acetaminophen, is a commonly used painkiller that can have harmful effects on the body Liver injury induced by paracetamol and challenges associated with intentional and unintentional use Drug Toxicity and Poisoning Basicmedical Key