Drug-induced hepatotoxicity

2005

Research output: Contribution to journalArticle

170 Citations (Scopus)

Abstract

The removal from the marketplace of several widely prescribed drugs due to hepatotoxicity has attracted considerable attention. Now under extensive review are means by which we can better identify hepatic risk prior to federal approval. Assessment of risk-to-benefit ratios regarding a novel agent with hepatotoxicity issues (especially one for a life-threatening condition) requires considerable judgment and education on the part of prescribers and patients. The spectrum of drug-induced liver injury is broad with simulation of almost all unknown liver disorders. Drug-induced liver injuries often have a somewhat characteristic signature, as regards type of injury (hepatocellular vs cholestatic) and time of onset. The diagnosis of drug-induced liver injury is often one of exclusion with initial suspicion based on circumstantial evidence. Factors affecting susceptibility to drug-induced injury include age, sex, concomitant use of other drugs, and genetic polymorphism in metabolic pathways involved in activation or disposition of therapeutic drugs. Drug-drug interactions present particular problems in patients, often elderly, who are receiving several drugs simultaneously. Mechanisms of drug-induced liver injury are many and varied. With many drugs, intermediary products produced during metabolism are highly reactive and toxic. In these situations, the balance between the rate of production of the metabolite and the effectiveness of the drug may determine whether or not hepatic injury occurs.

Original languageEnglish (US)
JournalJournal of Clinical Gastroenterology
Volume39
Issue number4 SUPPL.
StatePublished - Apr 2005

Fingerprint

Chemical and Drug Induced Liver Injury
Pharmaceutical Preparations
Liver
Wounds and Injuries
Poisons
Genetic Polymorphisms
Metabolic Networks and Pathways
Drug Interactions
Education

Keywords

  • Acetaminophen
  • Drugs
  • Genetic polymorphism
  • Hepatotoxicity
  • Liver injury

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Drug-induced hepatotoxicity : 2005. / Maddrey, Willis C.

In: Journal of Clinical Gastroenterology, Vol. 39, No. 4 SUPPL., 04.2005.

Research output: Contribution to journalArticle

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