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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cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval.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.
A hepatotoxin (Gr., hepato = liver) is a toxic chemical substance that damages the liver.. It can be a side-effect, but hepatotoxins are also found naturally, such as microcystins and pyrrolizidine alkaloids, or in laboratory environments, such as carbon tetrachloride, or far more pervasively in the form of ethanol (drinking alcohol).
Pyrrolizidine alkaloidosis can result in damage to the liver, kidneys, heart, brain, smooth muscles, lungs, DNA, lesions all over the body, and could be a potential cause of cancer. [ 1 ] [ 2 ] Pyrrolizidine alkaloidosis is known by many other names such as "Pictou Disease" in Canada [ 3 ] and "Winton Disease" in New Zealand. [ 4 ]
Liver regeneration is the process by which the liver is able to replace damaged or lost liver tissue. The liver is the only visceral organ with the capacity to regenerate. [ 1 ] [ 2 ] The liver can regenerate after partial hepatectomy or injury due to hepatotoxic agents such as certain medications, toxins, or chemicals. [ 3 ]
They also raised concerns about the drug's safety, as 11 patients who received it during the trial died or required a liver transplant, compared with two patients on placebo.
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Drug-drug interactions can be of serious concern for patients who are undergoing multi-drug therapies. [5] Coadministration of chloroquine , an anti-malaria drug, and statins for treatment of cardiovascular diseases has been shown to cause inhibition of organic anion-transporting polypeptides (OATPs) and lead to systemic statin exposure.