Which medication is associated with hepatic necrosis and jaundice when ingested in massive doses?

Acetaminophen is well-known for its potential to cause hepatic necrosis and jaundice, particularly when taken in large quantities. This is due to the way acetaminophen is metabolized in the liver. Under normal circumstances, acetaminophen is safely processed and excreted. However, when massive doses are consumed, the liver's capacity to handle the drug is overwhelmed, leading to the depletion of glutathione, a crucial antioxidant that protects liver cells from damage.

As glutathione levels drop, a toxic metabolite of acetaminophen accumulates, resulting in cellular damage, liver injury, and eventually hepatic necrosis. The manifestation of these effects includes jaundice, which is characterized by the yellowing of the skin and eyes due to bilirubin buildup, a byproduct of liver dysfunction.

This condition is a significant medical emergency requiring prompt diagnosis and treatment, often involving the administration of N-acetylcysteine to replenish glutathione stores and mitigate liver damage. The recognition of acetaminophen's hepatotoxic potential, especially in overdose situations, distinguishes it from other medications listed, which typically do not share the same profile of severe liver injury from acute overdose.