Centrilobular zonal necrosis in liver is seen with which of the following drug?
**Core Concept**
Centrilobular zonal necrosis in the liver is a type of liver injury that occurs due to the selective vulnerability of the centrilobular area to hypoxia and toxin-induced damage. This region is rich in mitochondria, which are sensitive to ischemia and oxidative stress.
**Why the Correct Answer is Right**
The correct answer is acetaminophen (paracetamol). Acetaminophen-induced liver injury is a classic example of centrilobular zonal necrosis. When acetaminophen is metabolized, it produces a highly reactive metabolite that depletes glutathione levels in the liver, leading to the formation of reactive oxygen species and mitochondrial dysfunction. This ultimately results in the death of hepatocytes in the centrilobular region.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not relevant to the specific pattern of liver injury described in the question.
**Option B:** This option does not cause centrilobular zonal necrosis; rather, it causes a different pattern of liver injury.
**Option D:** This option is not a drug that is commonly associated with centrilobular zonal necrosis.
**Clinical Pearl / High-Yield Fact**
Acetaminophen-induced liver injury is a leading cause of acute liver failure in the United States, and it is often reversible with prompt treatment. However, the window for effective treatment is narrow, and early recognition is crucial.
**Correct Answer:** C. Acetaminophen (paracetamol)