moreover, this finding was repeated regardless of the time between ingestion and assessment.21 Thus, acute ethanol ingestion may serve as a protective mechanism against APAP hepatotoxicity, but whether this phenomena takes place only in alcoholic patients (versus nonalcoholic patients) is unclear.8,2022 The mechanism behind this interesting finding appears to be ethanols competitive utilization of the CYP 2E1 substrate, which diminishes the NAPQI byproduct of phase I APAP metabolism.21,22 Another suggested hypothesis is that ethanol may directly enhance the activity of NAD(P)H:quinone reductase, serving to reconvert quinone metabolites back to native APAP and thereby limiting the accumulation of toxic metabolites.21 Chronic alcohol ingestion, however, augments APAP hepatotoxicity by up-regulating, enhancing and increasing the synthesis and activity of CYP 2E1 and decreasing GSH stores and synthesis, thus enhancing liver necrosis and worsening prognosis.5,8,21 Chronic alcoholism and APAP overdose may potentiate liver failure, but there is no indication that the combination of alcoholism and taking therapeutic amounts of APAP will necessarily cause hepatotoxicity.21 Therefore, one has to be wary of characterizing all alcoholics as being at higher risk of APAP hepatotoxicity
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Phenolics and flavonoids act as an antioxidant through several pathways The most potent one is likely to be by scavenging the free radicals in which polyphenols carried out the breakdown of several free radical chain reactions ( Kaurinovic and Vastag, 2019 )
Thus, we may assume that inhaled forms of antioxidants can be more effective in COPD
