Medications and Toxins in certain patients and in certain levels can cause serious affects to the liver and other systems within the body.

Drug and Toxin -induced liver diseases are diseases of the liver that are caused by the following:

1.)  Over-the-counter medications and vitamins
2.)  Physician-prescribed medications
3.)  Illicit (“recreational”) drugs
4.)  Excessive Hormones
5.)  Excessive Herbs
6.)  Environmental toxins
7.)  Cleaning chemicals from home
8.)   others

Can cause hepatic injury or injury to the Liver

Symptoms:

  • Itching
  • Loss of appetite
  • Fatigue
  • Nausea
  • Abdominal pain
  • Jaundice  (yellowing of skin)
  • Increase in bruising
  • Edema
  • Ascites  – fluid in abdominal region
  • Kidney failure
  • Mental status changes

Blood work

  • Injury to liver can cause abnormal blood work related to the liver including:

1.)  AST (aspartate amino transferase)
2.)  ALT (alanie aminotransferase)
3.)  Alkaline Phosphatase
4.)  Bilirubin

Injury to Liver by Drugs

  • Can occur in several ways
  • Some drugs are directly injurious to the liver;
  • Some are changed [metabolized] by the liver into chemicals that can be injurious to the liver directly or indirectly.

 

There are three types of liver toxicity

1.)   Dose-dependent toxicity

2.)  Diosyncratic toxicity

3.)   Drug Allergy

Dose-dependent toxicity

  • Is related to the quantity of drug taken
  • Causes liver disease in most people if enough [to much] of the drug is taken.
  • The most important example of dose-dependent toxicity is Tylenol [Acetaminophen].

Idiosyncratic toxicity

  • Causes disease in only those few patients
  • These individuals have a genetic component
  • As a result the chemical changes of that specific drug, cause a build up of the drug or products.
  • The build up then causes damage to the liver.
  • This occurs very more often then expected
  • Occurs on average somewhere between 1-10 per 100,000.
  • Idiosyncratic liver disease is the most common form of drug-induced liver disease because tens of millions of individuals are using drugs, and many of them are using several drugs.

Drug allergy

  • Also can cause liver disease
  • This is much less common
  • With a drug allergy, the liver is injured by the inflammation
  • The immune system is attacking the drugs and liver with antibodies and immune cells.

Most common medications:

  • NSAIDs
  • Analgesics
  • Antibiotics
  • others

Others toxins:

  • Alcohol
  • Heavy metals
  • Chloroform
  • others
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