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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cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval.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).
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 ]
Tolvaptan was studied in DILIsym®, a state of the art, multiscale computational model that uses non-clinical and clinical drug data to predict whether a drug could cause idiosyncratic liver toxicity. [16] DILIsym® replicated accurately the liver toxicity observed with tolvaptan in clinical studies. [17]
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.
In March 2024, the U.S. Food and Drug Administration (FDA) approved resmetirom — sold under the brand name Rezdiffra® — for people with NASH and moderate to advanced liver scarring.
Toxication, toxification or toxicity exaltation is the conversion of a chemical compound into a more toxic form in living organisms or in substrates such as soil or water. The conversion can be caused by enzymatic metabolism in the organisms, as well as by abiotic chemical reactions .