- An article on drug
induced liver injury published in the AACN Advanced Critical Care
Journal reports that 1000 drugs could lead to liver toxicity.
was found to cause 46% of drug-induced liver injury as it is available over the
counter and found in painkillers.
persons out of 10,000 exposed are at a risk for drug-induced liver
- The drug toxicity could be due to an adverse immune
response or biochemical damage to the cell.
injury (DILI) is now associated with the use of over 1000 medications,
including the commonly used acetaminophen
. In a recent paper published in the Journal AACN Advanced
, the medications that cause DILI are discussed.
10 persons in every
10,000 people who are exposed to the medications develop DILI, but
identification of the condition could mean recovery or severe liver failure or
even death. Clinical professor Dr. Angela Collins-Yoder, from The University of
Alabama Capstone College of Nursing, Tuscaloosa, said "The liver helps remove
toxins, which makes it especially vulnerable to injury from either short-term
intake above recommended levels or long-term usage that allows toxins to build
up. Recognizing the clinical signs and symptoms is crucial to prompt treatment
and effective patient care."
‘Drug reactions should be carefully monitored to avoid complications.’
damage is one of the frequent causes of liver damage. The symptoms of the
condition can follow any pattern of chronic or acute liver failure, making
identification difficult. Sometimes, the drug-induced symptoms subside after
the drug is stopped, which poses a therapeutic challenge for physicians.
of Drug-induced Liver Damage
The effect of drugs that
leads to liver damage follows either a predictable path or an unpredictable
one. Predictable effect is caused mainly due to paracetamol and the drug
reaction is seen within a few days of the drug toxicity
. The unpredictable effect
results in a drug reaction that may produce effects after a few months to even
one year later.
Chemicals are metabolized
in the liver, which is the reason why the organ is susceptible to adverse drug
reactions. The drug induced toxicity is due to the involvement of the drug or
its metabolites and it acts by either
Factors for Drug-Induced Liver Injury:
- Eliciting an immune
- Or by affecting the biochemistry of the
The risk factors are
- Mitochondrial effects
- Reaction to drugs
Associated with Drug-Induced Liver Injury
of other diseases
The symptoms that are
associated with drug-induced liver injury include
- Veno-occlusive disease
- Atypical hepatitis
injury due to acetaminophen constitutes 46% of incidences in the U.S. This
could be because acetaminophen is a constituent of painkillers that are
available over the counter. Overdosing on these painkillers could be the reason
behind the increased toxicity.
Medications That Trigger DILI
Some of the other
medications that are mentioned in the article include
injury occurs frequently and can mimic other liver diseases. It should be
diagnosed at the earliest with treatment provided at the earliest. Though
certain form of drug reactions subside after the drug is stopped, some drug
reactions can become life threatening. Drugs that give rise to predictable drug
reactions are normally eliminated at the clinical trial of drug development,
however, drugs that produce an unpredictable response may be difficult to
toxicity is important, both for pharmaceutical companies as well as for
physicians. The application of new fields in medicine like pharmacogenomics to
understand genetic variations that dictate drug reaction will play a key role
in identifying potential susceptibility.
The current study serves
as a warning to limit the use of the drugs listed and to monitor
patients for any adverse reactions.
- Drug-Induced Liver Injury - (http://cid.oxfordjournals.org/content/38/Supplement_2/S44.full)