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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cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval.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.
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).
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.
Footnotes: a = Time until death after onset of liver toxicity. b = Probably related to ethinylestradiol rather than to cyproterone acetate. [31] Notes: Many additional cases have been described in spontaneous adverse drug reaction reporting systems of individual countries.
Enterohepatic circulation of drugs describes the process by which drugs are conjugated to glucuronic acid in the liver, excreted into bile, metabolized back into the free drug by intestinal bacteria, and the drug is then reabsorbed into plasma.
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 ]
for liver transplantation in acute liver failure [25] Patients with paracetamol toxicity. pH < 7.3 or Prothrombin time > 100 seconds and serum creatinine level > 3.4 mg/dL (> 300 μmol/L) if in grade III or IV encephalopathy. Other patients. Prothrombin time > 100 seconds or Three of the following variables: Age < 10 yr or > 40 years; Cause ...
Hepatic veno-occlusive disease (VOD) or veno-occlusive disease with immunodeficiency is a potentially life-threatening condition in which some of the small veins in the liver are obstructed. It is a complication of high-dose chemotherapy given before a bone marrow transplant or excessive exposure to hepatotoxic pyrrolizidine alkaloids .