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What drugs are associated with causing focal to massive hepatic necrosis, and how do they induce such severe damage to the liver?

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Final answer:

Several drugs are associated with causing focal to massive hepatic necrosis, and they induce severe damage to the liver through various mechanisms.

Step-by-step explanation:

Several drugs are associated with causing focal to massive hepatic necrosis, which is severe liver damage. These drugs include:

  • Acetaminophen (Tylenol) - when taken in excessive doses
  • Antituberculosis drugs like isoniazid and rifampin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen
  • Antiepileptic drugs like phenytoin and valproic acid
  • Amoxicillin-clavulanate

These drugs induce severe damage to the liver through various mechanisms, including direct hepatotoxicity, immune-mediated injury, and metabolic disruption. For example, acetaminophen can cause liver damage by depleting glutathione and forming toxic metabolites that damage hepatocytes.

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