| What is drug induced hepatitis? | hepatotoxicity by drugs, most common cause of FHF
more than 90% are subclinical (mostly Abx and antihyperlipidema)
Can vary from subclinical to acute injury (cyto or chole) to chronic injury to vascular or granuloma or neoplasia.
Most elevations are benign and resolve when offending agent is done. |
| What are drugs causing acute liver injury? | Cytotoxic (acetaminophen, phenytoin, methyldopa)
Cholestatcic (TMB-sulfa (bactrim), rifampin, erythromycin, amiodarone, chloropromazine)
Mixed (phenytoin, increased risk of chronic disease)
Steatosis (tetracyclin, amiodarone, microvesicular) |
| What are drug induced chronic liver injuries? | Autoimmune like, viral like, necroinflammatory, steatosis (glucocorticoids...), fibrosis (amiodarone, methotrexate, methyldopa)
Intrahepatic cholestasis (ampicillin, amoxicillin-clavulanate, erythromycin, tetracyclin.
Biliary sclerosis, vascular disease (veno-occlusive vit A or COC, or azathioprine) |
| How is the dx of drug induced hepatitis? | Can be very difficult, due to multiple meds taken.
To ensure it is right, exposure should precede injury, liver diseases all negative, improve after stopping the drug. |
| How is the treatment of drug-induced hepatitis? | Withdrawal of drug |
| A 45 year old pt comes to ER for jaundice upon workup CBC normal and LFT elevated, all labs serology, ANA, meds, cirrhosis are negative what is cause? | Herbs (aleovera (can cause irreversible injury and renal injury)) |
