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5'-nucleotidase NT5E Prostaglandin G/H synthase 2 Prostaglandin G/H synthase 1 Prostaglandin G/H synthase 2 Prostaglandin G/H synthase 1 Solute carrier family 22 member 6 Prostaglandin E synthase Prostacyclin synthase Thromboxane-A synthase Cytosolic phospholipase A2 Acetaminophen Acetaminophen Acetaminophen Prostaglandin H2 Prostaglandin E2 Prostaglandin I2 Thromboxane A2 H2O Prostaglandin G2 Arachidonic acid O2 3-hydroxy-L- kynurenine 1-Methylhistidine Heme Heme Heme Heme Glutathione Heme Acceptor Reduced acceptor Phospholipids Organic halide Heme Calcium Endoplasmic Reticulum Cytosol Acetaminophen enters the cell via the solute carrier family 22 member 6 transporter. Extracellular space Acetaminophen inhibits COX-1 & COX-2 (prostaglandin G/H synthase 1&2) on the endoplasmic reticulum membrane, preventing the conversion of arachidonic acid into PGH2. Prostaglandin synthesis is reduced. Lowered levels of prostaglandin E2 , which is responsible for pain and fever. This effect on prostaglandin E2 is responsible for the antipyretic and associated with acetaminophen. Inflamed Cell