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The oxidation of acetaminophen (4'-hydroxyacetanilide) to the corresponding N-acetyl-p-benzoquinone imines by plant and mammalian peroxidases is discussed. The acetaminophen free radical (N-acetyl-4aminophenoxyl) has been reported as an intermediate. It is very reactive and forms melanin-like polymeric products. Application of a fast-flow system makes it possible to detect the transient species and clearly distinguish it from persistent paramagnetic melanin polymers.A model system, leading to more stable metabolites, can be obtained by introduction of methyl groups next to the oxygen, 3',5'-dimethylacetaminophen (3',5'-dimethyl-4'-hydroxyacetanilide). The ESR spectrum of the free radical formed could be completely analyzed and confirmed by deuterium substitution. The data are consistent with the assignment to a phenoxyl free radical (N-acetyl-2,6-dimethyl-4-aminophenoxyl). Its formation is discussed in terms of substrate, hydrogen peroxide and enzyme concentration dependence. It is believed to be formed via a direct one-electron oxidation of 3',5'-dimethyl-4'-hydroxyacetanilide.The radical does not form polymers or react with nucleophiles. Its redox behavior is discussed. The possible reaction of these phenoxyl free radicals with oxygen is thought to be negligible. Acetaminophen (4'-hydroxyacetanilide) is a commonly used, mild analgesic drug which has gained acceptance as a salicylate (aspirin) substitute. Although it is considered safe in normal dosage, ingestion of large quantities of acetaminophen can result in hepatic necrosis and acute renal failure in man (1,2). This toxicity has been attributed to the formation of a highly reactive metabolic species, the N-acetyl-p-benzoquinone imine (3,4), which is thought to bind covalently to protein in vivo. Under therapeutic dose conditions, tissue glutathione appears to protect against hepatic damage by binding to the N-acetyl-p-benzoquinone imine, as evidenced by acetaminophen dose-dependent depletion of liver glutathione (5,6). When acetaminophen is present in excess, however, the glutathione levels are depleted, leading to covalent binding of the arylating metabolite to tissue macromolecules and hepatic cell death (6,7). Several mechanisms for N-acetyl-p-benzoquinone imine formation have been proposed. Metabolic activation might occur through N-oxidation of acetaminophen to N-hydroxyacetaminophen, followed by dehydration to the arylating N-acetyl-p-benzoquinone imine (8) [Eq.(1)].