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Consequently, changes in definite cytochrome P450 enzymes, as those previously evidenced in livers of patients with steatosis, but also in vivo models of steatosis (in experimental animals) and in vitro models of fat-overloaded cells, pose major impact on drug-induced hepatotoxicity (Gmez-Lechn et al., 2009), on the basis that CYP 3A4 is the main responsible for the metabolism of fentanyl (Figure 2) (Tateishi et al., 1996)

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