Which of the following is a common side effect of acetaminophen overdose?

Acetaminophen overdose primarily leads to liver damage due to the way the body metabolizes the drug. In normal therapeutic doses, acetaminophen is metabolized mostly by the liver through safe pathways. However, when taken in excessive amounts, the liver's ability to process the drug is overwhelmed, leading to an accumulation of toxic metabolites, specifically N-acetyl-p-benzoquinone imine (NAPQI). This toxic metabolite can cause significant hepatocyte injury, resulting in acute liver failure if not treated promptly.

The other options, while related to potential complications from different conditions or medications, are not typically associated with acetaminophen overdose. Kidney failure may occur in severe cases or due to other nephrotoxic agents but is not a direct consequence of acetaminophen toxicity. Gastrointestinal bleeding is more commonly related to nonsteroidal anti-inflammatory drugs (NSAIDs) or certain anticoagulants rather than acetaminophen. Neurologic disorders may arise from various factors or drug interactions but are not a typical or direct outcome of acetaminophen overdose. Therefore, liver damage is the most characteristic and well-documented consequence of excessive acetaminophen intake.