Journal of Liver

Understanding and Prevention of Medication-Associated Hepatic Destruction

Fredrik Tuominen^* Department of Surgery and Transplantation, University of Helsinki, Helsinki, Finland
^*Correspondence: Fredrik Tuominen, Department of Surgery and Transplantation, University of Helsinki, Helsinki, Finland, Email:

Received: 01-Nov-2023, Manuscript No. JLR-23-23554; Editor assigned: 03-Nov-2023, Pre QC No. JLR-23-23554(PQ); Reviewed: 23-Nov-2023, QC No. JLR-23-23554; Revised: 01-Dec-2023, Manuscript No. JLR-23-23554(R); Published: 08-Dec-2023, DOI: 10.35248/2167-0889.23.12.201

Description

Drug-induced liver inflammation, also known as Drug-Induced Liver Injury (DILI), is a significant and complex medical issue that arises when the liver's normal function is compromised due to exposure to various drugs, toxins, or herbal supplements. It carries out a multitude of functions, such as detoxifying harmful substances, producing essential proteins, breaking down fats, regulating blood sugar levels, and storing energy. However, when certain drugs or toxins enter the system, they can damage liver cells and disrupt these essential functions, leading to a range of symptoms and complications. There are different types of druginduced liver injury, each characterized by the cause, mechanism, and severity of the liver damage. Hepatocellular Injury directly affects the liver cells, known as hepatocytes, causing them to become dysfunctional or even die. One of the most common causes of hepatocellular injury is an overdose of acetaminophen (paracetamol), a widely used pain reliever. Acetaminophen overdose can result in acute liver failure if not promptly treated. Other drugs and substances known to cause hepatocellular injury include certain anti-tuberculosis medications, anti-seizure drugs, cholesterol-lowering statins, and herbal supplements. Symptoms of hepatocellular injury may include elevated levels of liver enzymes (such as AST and ALT) in the blood, jaundice, nausea, vomiting, abdominal pain, and fatigue.

In Cholestatic injury the bile ducts, which are responsible for transporting bile from the liver to the intestine, become inflamed or obstructed. Antibiotics like amoxicillin-clavulanate, erythromycin, and trimethoprim-sulfamethoxazole are common culprits of cholestatic injury. Other medications that can cause this condition include oral contraceptives, anabolic steroids, and chlorpromazine. Symptoms of cholestatic injury may include elevated levels of Alkaline Phosphatase (ALP) and bilirubin in the blood, as well as jaundice, itching, dark urine, and pale stools. Mixed injury is a combination of both hepatocellular and cholestatic features, affecting both liver cells and the bile ducts. Alcohol abuse is a primary cause of mixed injury, potentially leading to conditions like alcoholic hepatitis or cirrhosis. Other substances that can cause mixed injury include anti-inflammatory drugs like ibuprofen and naproxen, anti-fungal medications such as ketoconazole and fluconazole, and anti-cancer drugs like methotrexate and tamoxifen. Symptoms may include elevated levels of AST, ALT, ALP, and bilirubin in the blood, jaundice, abdominal pain, fluid accumulation in the abdomen (ascites), and variceal bleeding (rupture of enlarged veins in the esophagus or stomach). Diagnosis of drug-induced liver inflammation is typically based on a combination of factors, including the patient's history of drug exposure, clinical symptoms, and results from laboratory tests. In some cases, a liver biopsy may be performed to assess the extent of liver damage. Timely and accurate diagnosis is essential for determining the appropriate course of treatment.

Treatment for drug-induced liver inflammation primarily involves discontinuing the use of the offending drug or toxin. Stopping exposure to the causative agent is the most critical step in preventing further liver damage and allowing the liver to heal. In specific cases, such as acetaminophen overdose or poisoning from certain wild mushrooms, healthcare providers may administer specific antidotes to counteract the toxic effects. Supportive care is an important component of treatment and can include intravenous fluids to maintain hydration, anti-nausea medications to alleviate symptoms, pain relievers, vitamins, and nutritional supplements to help patients cope with their condition and prevent complications. In severe or irreversible cases of liver failure that do not respond to other treatments, a liver transplant may be considered. This procedure involves replacing the damaged liver with a healthy one from a donor, providing the patient a chance for initiation.

Conclusion

It is imperative for individuals to be aware of the potential risks associated with certain drugs and toxins, and to consult a healthcare professional if any signs or symptoms of liver injury surface. The choice of diagnostic methods depends on the patient's clinical presentation, medical history, and the availability of healthcare resources. Medical professionals will carefully evaluate each case to determine the most appropriate diagnostic and treatment approach, emphasizing the importance of tailored and patient-centered care.