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Hy's law is a rule of thumb that a patient is at high risk of a fatal drug-induced liver injury if given a medication that causes hepatocellular injury (not Hepatobiliary injury) with jaundice. [1] The law is based on observations by Hy Zimmerman, a major scholar of drug-induced liver injury.
Risk factors known as of 2010 are: Quantity of alcohol taken: Consumption of 60–80 g per day (14 g is considered one standard drink in the US, e.g. 1 + 1 ⁄ 2 US fl oz or 44 mL hard liquor, 5 US fl oz or 150 mL wine, 12 US fl oz or 350 mL beer; drinking a six-pack of 5% ABV beer daily would be 84 g and just over the upper limit) for 20 years or more in men, or 20 g/day for women ...
Alcoholic hepatitis by itself does not lead to cirrhosis, but cirrhosis is more common in patients with long term alcohol consumption. [6] Some alcoholics develop acute hepatitis as an inflammatory reaction to the cells affected by fatty change. [6] This is not directly related to the dose of alcohol.
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. [ 3 ] [ 6 ] Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme metabolism , liver dysfunction , or biliary-tract obstruction. [ 7 ]
Examples of drugs include rifampin, sulfa drug and ethinyl estradiol respectively. [3] Alcohol significantly increases risk of hyperbilirubinemia through causing liver damage that hinders bilirubin uptake and metabolism. Long-term heavy alcohol consumption induces steatosis and hepatitis, possibly progressing to cirrhosis. [6]
Treatment of the condition is specific to the cause of hemolysis, but intense phototherapy and exchange transfusion can be used to help the patient excrete accumulated bilirubin. [11] Complications related to hemolytic jaundice include hyperbilirubinemia and chronic bilirubin encephalopathy, which may be deadly without proper treatment. [12] [13]
As heroin use rose, so did overdose deaths. The statistics are overwhelming. In a study released this past fall examining 28 states, the CDC found that heroin deaths doubled between 2010 and 2012. The CDC reported recently that heroin-related overdose deaths jumped 39 percent nationwide between 2012 and 2013, surging to 8,257.
Acute alcohol poisoning is a medical emergency due to the risk of death from respiratory depression or aspiration of vomit if vomiting occurs while the person is unresponsive. Emergency treatment strives to stabilize and maintain an open airway and sufficient breathing while waiting for the alcohol to metabolize.