Which of the following effects of alcohol most likely contributed to this patient’s condition? A previously healthy 42-year old Asian woman is brought to the emergency department because of a 24-hour history of nausea, vomiting and progressive lethargy. She has smoked 1 pack of cigarettes daily for 25 years and drinks four glasses of wine daily. She uses high-dose acetaminophen daily for headaches. She does not use illicit drugs. She is 155 cm (5ft 1 in) tall and weighs 50 kg (110 lb); BMI is 21 kg/m2. She is responsive to painful stimuli. Initial laboratory studies show increased hepatic aminotransferase.
A. Decreased generation of N-acetyl-p-benzoquinonelmine B. Increased glucuronidation C. Increased hepatic glutathione stores D. Increased sulfation E. Induction of cytochrome P450