In a 79 year old obese female patient presenting early cirrhosis (shown in MRI and CT imaging studies for several years prior)
with malnutrition secondary to chemotherapy (patient's weight had decreased from 235 lbs. to 170 lbs. over the course of 1 year),
Patient had a bout of dehydration 18 days prior to the date in question which required I.V. electrolytes.
Patient was receiving Primidone 50mg per day oraly for a bilateral pedal resting cyclonic tremor, believed secondary to chemotherapy, and Decadron 10mg per day oraly as an appetite booster, both of which induce P-450 enzymes , these coconmittant medications began 13 days prior to the date in question.
Edit: patient also presented AVM's in the sigmoid colon, and recent imaging uncovered suspected diverticulitis /colitis, believed responsible for a condition of chronic anemia which evaded detection by both repeated upper and lower endoscopic procedures and cam swallow studys
Could the administration of Hydrocodone/APAP 5/500 in three doses totaling 1500mg acetaminophen coconmittantly with Decadron and Primidone possibly result in acute liver failure in a patient presenting this history?