Title : Drug-Induced Liver Disease
link : Drug-Induced Liver Disease
Drug-Induced Liver Disease
What is drug-induced liver disease?
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diseases induced by drugs unit area of liver diseases of the liver unit area caused by medications prescribed by the doctor, excess counter medications , vitamins, hormones, herbs, ( "recreational") illicit medicine, and environmental toxins.
What is the liver?
The liver is the organ associate nursing that is placed within the highest right side of the abdomen, mostly behind the skeletal structure. The liver of an adult associate nursing typically weighs about 3 pounds and has several functions.
The liver produces and secretes digestive juices in the internal organ where digestive juice assists with digestion of fats in the diet.
The liver helps purify the blood by ever-changing undoubtedly harmful chemicals into harmless ones. The sources of these chemicals may be outside the body (for example, drugs or alcohol), or within the body (for example, ammonia, that is created from the breakdown of protein, or haematoidin, which is created from the breakdown of hemoglobin).
The liver removes chemicals from the blood (usually always changing them into harmless chemicals) so either the secret with the digestive juice for disposal within the stool, or secretes them back into the blood wherever area unit then eliminated by the kidneys and eliminated in the stool.
The liver produces several necessary, in particular proteins unit area required permanently health substances. as an example, macromolecules occurs as single proteins (the protein that carries alternative molecules through the bloodstream), yet because the proteins that cause blood to clot properly.
Illustration liver
Illustration liver
When medicine damage the liver and alter their traditional surgery, symptoms, signs and abnormal blood tests for the disease. Anomalies unit area of liver disease drug-induced almost like liver disease caused by alternative agents such as viruses and diseases of medical specialties. as an example, infectious disease drug (inflammation of liver cells) induced infective agent is analogous to hepatitis; each of them will cause elevations in blood levels of aspartate aminotransferase (AST) and transferase aminoalkanoic acid (ALT) (enzymes leak from the liver and black and blue and blood) continues as eating disorders (loss of desire), fatigue and nausea. Drug-induced annoying (interference with the flow of digestive juices which is caused by injury to the ducts of digestive juices) discomfort disease response mimic (eg primary liver or PBC biliary cirrhosis) and may cause elevations in blood levels of haematoidin (causing jaundice), alkaline enzyme (a protein that leaked duct digestive juices black and blue), and itching.
What area unit of the symptoms of liver disease?
Patients with mild disease may have few or no symptoms or signs. Patients with a lot of serious illness symptoms and signs are nonspecific or specific.
nonspecific symptoms (symptoms can also be seen in alternative disorders) include:
fatigue,
weakness,
vague abdominal pain, and
loss of desire.
Symptoms and signs unit specific surface for the disease include:
yellowing of the skin (jaundice) as a result of the accumulation of haematoidin in blood
itching associated with disease, and
bruise easily as a result of production of coagulation factors shrunken unhealthy liver.
advanced disease with severe liver cirrhosis resulting symptoms and signs associated with cirrhosis; These symptoms include:
fluid accumulation in the legs (edema) and abdomen (ascites, as a result of increased pressure within the vessels entering the liver)
mental confusion or coma (viscera neurological disease as a result of increased ammonia)
renal failure,
vulnerability to infections by microorganisms, and
gastrointestinal damage secondary to varices (enlarged blood vessels within the muscle structure or stomach).
Taking cause liver disease?
Drugs cause disease in many ways in which. Some unit area of directly detrimental to the liver medicine; unit area than other reprocessed by the liver into chemicals that can cause liver damage, directly or indirectly. (This may seem strange at lightweight the necessary role of the liver in the remodeling of chemicals in cyanogenic non-toxic chemicals, however it happens.) There are 3 types unit area of liver toxicity; dose-dependent toxicity, individual toxicity, and drug hypersensitivity reaction.
Drugs that cause dose-dependent toxicity cause disease in the general population, if enough of the drug is taken. Example necessary primarily dependent toxicity is dose Tempra (Tylenol) drug (discussed later in this article.).
Drugs that cause individual toxicity cause disease in just the few patients who have specific genes inheritable that the management of the chemical transformation of that specific drug, causing accumulation of the drug or product transformation (metabolites) that unit detrimental to the liver area. These individual toxicities inheritable sometimes rare unit area, and a commitment to the drug, usually occur at least one a10 percent, 000 area patients taking the drug unit; but, with a little medicine toxicity prevalence it is much higher. even if the likelihood of developing individual disease induced by drugs is low, individual disease is the most common style of the disease by drug induced as a result of dozens of incommensurable patient area medical unit of victimization, and lots of them victimization unit surface many medicine.
Idiosyncratic drug toxicity is problematic found in early clinical trials typically involve, at most, only many thousands of patients. Toxicity individual can emerge only when patients begin to receive incommensurable drug when the drug is approved by the government agency.
hypersensitivity reaction to drugs also may cause the disease, although it is rare. In drug hypersensitivity reaction, the liver is black and blue by inflammation that occurs once the system of the body attacks the medicine with antibodies and immune cells.
What type of jack disease causes?
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Drugs and chemicals cause a good spectrum of liver injury. These include:
mild elevations in blood levels of liver enzymes, while no symptoms or signs of disease
Hepatitis (inflammation of liver cells)
Necrosis (death of cells liver) which is always caused by a lot of serious infectious diseases
cholestasis (decreased secretion and / or flow of bile)
the steatosis (fat accumulation in the liver)
cirrhosis ( advanced scarring of the liver) as a result of chronic infectious disease, disorder or liver disease
mixed disease, as an example of each infectious disease and the death of liver cells, infectious diseases and the accumulation of fat, or stomach and infectious disease.
infectious disease severe acute with severe hepatic impairment, risk of death
Blood clots in the veins of the liver
Elevated levels of liver enzymes
Many drugs cause elevations soft in blood levels of liver while no symptoms or signs of infectious disease enzymes. AST, ALT, and enzymes alkaline enzyme unit area normally resident within the liver cells and ducts digestive juice. Some medications make these enzymes leaking blood cells and, therefore, the elevated blood levels of enzymes. samples of medicine that many often cause increases in liver enzymes in the blood include statins (used in the treatment of high blood cholesterin levels) some antibiotics, some antidepressants (used to treat depression), and some medications used to treat polygenic disease, tacrine (Cognex), aspirin and Quinora (Quinaglute, Quinidex).
Because these patients usually experience no symptoms or signs, increases in liver enzymes sometimes unit area discovered once the unit area of blood tests done as a city associated nursing annual physical exam, such as pre-operative research, or as a locality of the periodic observation of drug toxicity. Usually, these abnormal levels may soon become traditional when the drug is stopped, and sometimes there is not any long liver injury. With a little medicine, low levels of abnormal liver enzymes common unit area and do not seem related to necessary (severe or progressive) of the disease, and the patient may continue taking the drug.
acute and chronic infectious disease
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Some medicines cause acute infectious disease and chronic (inflammation of liver cells) that can cause death (death ) cells. Acute drug-induced infectious disease emerges as infectious disease that lasts longer than three months, while chronic infectious disease lasts longer than three months. acute infectious disease is drug-induced now a lot of common chronic infectious disease drug induced.
Typical symptoms of infectious disease induced by drugs include:
loss of appetite,
nausea,
vomiting
fever
weakness,
fatigue, and
abdominal pain.
In severe cases, patients develop dark stools, fever, light-colored stools, and jaundice (a yellowish look of the skin and whites of the eyes). Patients with infectious disease sometimes have high levels of AST, ALT and haematoidin. each acute and chronic infectious disease usually resolves when the drug is stopped, however usually acute infectious diseases can be severe enough to cause acute liver failure (see later in this article), and chronic infectious disease rarely, cause permanent liver damage and cirrhosis of the liver.
Examples of drugs that can cause an acute infectious disease embrace Tempra (Tylenol), phenytoin (Dilantin), aspirin, antibacterial drugs (Nydrazid, Laniazid), diclofenac (Voltaren), and amoxicillin / clavulanate (Augmentin ).
Examples of drugs that can cause a chronic infectious disease embrace Achromycin (Minocin), antibacterial drugs (Furadantin, Macrodantina), phenytoin (Dilantin), organic compound, fenofibrate (Tricor) and glass ( "ecstasy") ..
the acute liver failure
rarely, medicine cause acute renal failure (fulminant hepatitis). These unit area very ill patients with symptoms of acute infectious disease and also the additional problems of confusion or coma (encephalopathy) and bruising or damage (coagulopathy). In fact, the ninetieth seventieth individuals with infectious disease die suddenly. Within the US, Tempra (Tylenol) is the most common after acute liver failure reason.
cholestasis
cholestasis may be a condition in which the secretion and / or flow of digestive juices is reduced. haematoidin acids and digestive juice normally secreted by the liver into the digestive juice and eliminated from the body through the internal body, they accumulate in the body as a result of jaundice and itching, severally. inflict malaise medicine interferes with the secretion of digestive juices liver cell, while not inflict infectious disease or death of liver cells (death). Disorder patients blood levels usually have high drug induced haematoidin however, have traditional or slightly elevated AST levels and altitude. Blood levels of alkaline phosphate (a protein created by ducts digestive juices) increase as a result of digestive juices cells are also conduits and leak dysfunctional protein. in addition to itching and jaundice, patients sometimes do not seem to be as sick as patients with acute infectious disease.
Examples of medicine that are reported to cause discomfort to embrace antibiotics (E-Mycin, Ilosone), Thorazine (Thorazine), sulfonamides and trimethoprim (Bactrim, Septra), tricyclics (Elavil, Endep), carbamazepine (Tegretol), Principen (Omnipen; Polycillin, Principen), ampicillin / clavulanate (Augmentin), antibacterial (Rifadin), estrogen (estradiol; Climara; Estraderm; Menostar), ACE inhibitor (captopril), contraceptive pills ( oral) contraceptives, anabolic steroids, nonsteroidal anti-inflammatory (Naprosyn), antiarrhythmic (Cordarone), neuroleptics (Haldol), tricyclics (imipramine), antibacterial drugs (Achromycin) and phenytoin (Dilantin).
Most patients with discomfort induced by drugs can fully recover within weeks when the drug is stopped, however, in some patients, jaundice, pruritus and abnormal liver tests last month after you stop taking the medicine . Associated Nursing occasional patient will develop chronic disease and liver failure. Jaundice induced by drugs and discomfort that lasts more than three months is called chronic discomfort.
The steatosis (fatty liver)
The most common causes of fat accumulation within the unit area alcoholism liver and nonalcoholic fatty liver {| } disease liver disease (NASH) in relation to fat and polygenic disease. drug can cause liver disease or infectious diseases, while unassociated. Patients with drug-induced liver disease may have only many symptoms, or none. They generally have mild elevations in blood levels of AST and moderate altitude, and also can develop enlarged livers. In severe cases, liver disease cause drug-induced liver cirrhosis and liver failure.
Drugs reported to cause liver disease embrace the overall nutrition of the duct, with immune suppressing drugs (Rheumatrex), antifungal agent (Grifulvin V), antagonist of estrogen (Nolvadex), steroids, valproate (Depakote) and antiarrhythmic (Cordarone).
In things insurance, liver disease alone can be life threatening. as an example, the syndrome may be a rare disease that can cause liver disease, liver failure and coma. It is believed to occur in children and adolescents with respiratory disorder after unit area given aspirin. Another example of significant liver disease is caused by high doses of intravenous or antiarrhythmic antibacterial drug. insurance herb (eg Bu Huan Jin Chinese herb, used as a sedative and analgesic) can also cause severe liver disease.
Cirrhosis
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chronic liver diseases such as annoying infectious disease, liver disease, or cause death (death) of liver cells. forms of connective tissue, as part of the healing method is related to liver cells die, and severe scarring of the liver will cause cirrhosis of the liver.
The most common example of drug-induced cirrhosis of the liver is alcoholic liver cirrhosis. samples of medications that can cause chronic liver disease and cirrhosis of the liver embrace immune suppressant drug (Rheumatrex), antiarrhythmic (Cordarone) and antihypertensive (Aldomet). Please scan the article on cirrhosis of the liver for a lot of information.
Occlusion of the hepatic vein
Normally, blood from the intestines is delivered to the liver through the Portae vein, and the blood that is outside the liver for casings it is carried through the veins of viscera in the venous blood vessel bottom (the massive vein that drains into the heart). Safe medication cause blood clots that do (thrombosis) in the veins of viscera and into the lower venous blood vessel. venous occlusion associated blood vessel in venous blood vessel bottom Nursingd cause an enlarged liver, abdominal pain, assortment of fluid in the abdomen (ascites), and liver failure. This syndrome is called Budd Chiari syndrome. the medication necessary first of all to cause contraceptive pills unit area of Budd-Chiari syndrome (oral contraceptives). Contraceptive pills can also cause a connected disease known as veno-occlusive disease in which blood clots in the veins only smaller viscera. these alkaloids found in the safe herbs (such as borage, comfrey) can also cause veno-occlusive disease.
How drug-induced disease diagnosed?
The diagnosis of drug-induced liver diseases is often problematic. Patients may have no symptoms of the disease or the symptoms may have only mild, non-specific. Patients may also take multiple medicine, which makes it annoying to detect the drug in violation. Patients also can produce other potential causes of liver illnesss, such as liver disease nonalcoholic disease (NAFLD) and alcoholism.
The diagnosis of the disease is based on the patient's symptoms (eg, loss of desire, nausea, fatigue, itching and dark urine), findings on physical examination (such as jaundice, enlarged liver ), and abnormal laboratory tests (such as blood levels of liver enzymes or haematoidin times and coagulation). If a patient has symptoms, signs and abnormal liver tests, doctors then try to decide whether or not the drug (s) unit area inflict disease
Taking a careful history of alcohol to exclude alcoholic disease.
Conducting blood tests to exclude hepatitis B and viral hepatitis, and to exclude chronic liver disease and response to infectious diseases and first liver biliary cirrhosis (PBC).
Conducting an abdominal ultrasound or computed tomography (CT) to exclude liver disease and liver tumors vesica.
Taking a detailed history of the initiation of ingestion, particularly recent -. Of medicine unit area usually related disease
center of origin / digestion digestion / az / List of drugs evoked the disease index / drug evoked article disease
Drug-induced disease
medical Author: Dennis Lee, MD medical Editor: Jay W. Marks, MD
ARTICLERELATED DISEASESIMAGES and QUIZZESINDEX
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What is drug-induced liver disease?
What is the liver?
What area unit of the symptoms of liver disease?
Taking cause liver disease?
What type of jack disease causes?
elevated levels of liver enzymes
acute infectious disease and chronic
Acute liver failure
cholestasis
The steatosis (fatty liver)
Cirrhosis
Occlusion of the hepatic vein
How drug-induced disease diagnosed?
What is the treatment for drug-induced liver disease?
What unit area needed some signs of drug-induced liver disease?
What is the treatment for drug-induced liver disease?
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The most necessary for drug-induced disease treatment is to stop the drug that is causing the disease. In most patients, the signs and symptoms of the disease may resolve and blood tests can become traditional and no long liver damage. Unit area There are exceptions, however. as an example, unit overdose of painkillers area treated with oral N-acetylcysteine to stop severe liver death and failure. Liver transplantation may also be necessary for some patients with acute liver failure. Some medications can also cause irreversible liver damage and cirrhosis of the liver.
What unit area needed some signs of drug-induced liver disease?
Acetaminophen (Tylenol)
A drug will Tempra liver lesions. The likelihood of injury {| injury | harm} yet because the severity of damage depends on the dose ingested Tempra; the top dose is undoubtedly a lot of is that there will be injuries and much, no doubt, is that the damage will be severe. (The reaction Tempra is dose-dependent and predictable, is not individual -. Peculiar person) Liver injury Associate drugs Nursing Tempra could be a very serious problem given the damage can be severe and lead to liver failure and death . In fact, Tempra drug is that the main reason for failure acute (rapid onset) liver within the US and the United Kingdom.
For the average healthy adult, most of the suggested dose Tempra in a whole number of 24 hours is four grams (4000 mg) tablets or extra eight strong. (Each tablet contains extra strong five hundred mg, while all regular strength tablets containing 325 mg.) Among children, the dose of Tempra is decided on the premise of weight and age of each child, expressly stated in the prospectus. If these tips for the unit and young adults area followed, Tempra is safe and leads first there is a risk of liver injury. someone who drinks more than 2 alcoholic drinks per day, however, should not take more than a couple of grams (2000 mg) of Tempra over twenty-four hours, as mentioned below, since alcohol makes prone to liver injuries Tempra lower doses.
A single dose of seven to ten grams (7000 - ten 000 mg) Tempra (14 to twenty super strong tablets), twice the suggested dose, cause liver damage in the average healthy adult. Among children, a dose of a kg (body weight) one hundred forty mg / Tempra can result in liver damage. still, three are reported to four grams ((3000 four000 mg) taken at a time very single dose or 4 to six grams (4000-6000 mg) over twenty four hours to cause severe liver damage in some people, in general , even to death. seems certain that people, as an example, people who usually drink alcohol, unit area of a lot of likely than others to develop paracetamol-induced liver injury. alternative factors that increase risk human injury by Tempra embrace the rapid state, deficiency disease, and concomitant administration of another medication such as phenytoin (Dilantin), phenobarbital, carbamazepine [(Tegretol) (anti-seizure medications)] or antibacterial drugs [(Nydrazid, Laniazid) (anti-TB drug)].
Please scan the article analgesic liver injury for a thorough discussion of symptoms, mechanisms of toxicity Tempra, treatment (early use of N-acetylcysteine), and the obstacle.
statins
statins unit used the main area wide loss drugs "bad" cholesterol (LDL) in order to stop heart attacks and strokes. Most physicians believe that statins unit area safe for use long, and the necessary liver injury is rare. Still, statins can damage the liver. the disadvantage related to the most important common liver is caused by statins mild elevations in blood levels of liver enzymes (ALT and AST), without symptoms. Sometimes these abnormalities improve or resolve completely stopping the medication or dose reduction. no permanent liver damage.
Patients with Associate in Nursing fat have magnified the likelihood of developing polygenic disease, nonalcoholic fatty liver {| } disease liver disease (NFALD), and elevated blood levels cholesterin. Patients with liver disease usually have no symptoms, and the unit area of abnormal tests once discovered blood test routine is completed. Recent studies have found that drugs can be used safely to treat high blood cholesterol in patients who have already gotten liver disease and abnormal liver function tests smoothly once the statin is started. In these patients, physicians might better use statins at lower doses and monitor liver protein levels often throughout treatment.
However, the individual capable of inflicting serious liver damage (including liver failure to produce liver transplant) liver toxicity has been reported with statins. The frequency of severe disease caused by satins is probably going within the range of 1-2 per million users. As a precaution, information labeling government agency reported that blood tests of liver protein should be performed before and twelve weeks after initiation of treatment with medication or increase the dosage, and sporadically thereafter (eg, every six months). Principen.
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