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Drug-induced liver injury (DILI) is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval. The liver plays a central role in transforming and clearing chemicals and is susceptible to the toxicity from these agents.
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.
In a large observational study of 2,506 patients, Heinemann et al. (1997) reported 7 cases of benign liver tumors and no cases of serious liver toxicity or HCC. [45] Large observational studies have found no increased risk of liver toxicity or HCC with cyproterone acetate at BCP doses.
This type of adverse effect that results from pharmaceutical drug exposure is commonly due to interactions of the drug with its intended target. In this case, both the therapeutic and toxic targets are the same. To avoid toxicity during treatment, many times the drug needs to be changed to target a different aspect of the illness or symptoms.
The CIOMS/RUCAM scale has been proposed to establish causal relationship between offending drug and liver damage. The CIOMS/RUCAM scale involves a scoring system which categorizes the suspicion into "definite or highly probable" (score > 8), "probable" (score 6-8), "possible" (score 3-5), "unlikely" (score 1-2) and "excluded" (score ≤ 0).
Analogous terms such as "drug-induced" or "toxic" liver disease are also used to refer to disorders caused by various drugs. [ 7 ] Fatty liver disease (hepatic steatosis ) is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells. [ 8 ]
HepaRG cell line is a human hepatic in vitro line used in liver biology research and for assessing liver pathology, hepatotoxicity, and drug-induced injury. The HepaRG model is considered a surrogate for Primary Human Hepatocytes, which are the most pertinent model to reproduce the human liver functioning as they express 99% of the same genes .
Patients with type 1 HRS are usually ill, may have low blood pressure, and may require therapy with drugs to improve the strength of heart muscle contraction or other drugs to maintain blood pressure (vasopressors). [5] Unlike type II, in type I hepatorenal syndrome the kidney failure improves with treatment and stabilizes.