Overview of Hepatotoxicity

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Overview of Hepatotoxicity

 

A number of drugs cause liver toxicity. The best indicator for liver toxicity

is an elevation in some enzymes measure in the blood, such as AST (aspartate

aminotransferase) ALT (alanine aminotransferase) and GOT (glutamate oxalacetate

transaminase). These enzymes should be monitored routinely in an annual

physical exam, more frequently if there is reason to suspect potential liver

disease.

 

If there is any reason to suspect that a drug has been causing liver injury,

then a blood test should be performed immediately. But it can be difficult to

begin suspecting a drug to have caused liver injury. The following signs and

symptoms of liver disease that an individual can feel are given to help to guess

when a blood test for liver damage might be justified. THE SYMPTOMS OF

HEPATOTOXICITY (liver damage) CAN BE MILD AND CAN ESCAPE NOTICE.

 

Hepatotoxicity can cause permanent injury and death. It is important to detect

hepatotoxicity in its early stages so that steps can be taken to arrest its

development and allow the liver to heal.

 

Initially hepatotoxicity may be marked by acute gastrointestinal symptoms,

including severe diarrhea. The second phase, is characterized by abatement of

symptoms. During this apparent subsidence, biochemical evidence of hepatic

injury appears. Oliguria is usual. The third phase, that of overt hepatic

damage, becomes clinically apparent 3 to 5 days after ingestion, with the

appearance of jaundice. Renal failure may occur. Can be fatal.

 

The symptoms of chemically-induced (drug-induced) hepatitis are similar to that

of infectious hepatitis. It is estimated that most individuals who develop

hepatitis A never notice it; but the body mounts and immune response, which then

protects the patient from subsequent infections. Of course, the body does not

mount an immune defense against drug-induced hepatitis.

 

Symptoms of hepatitis:

anorexia (loss of appetite)general malaise (feeling unwell)nauseavomitingbrown

urinelight-colored stoolsunusual tiredness / weaknessstomach or abdominal

painjaundice (yellowing of the skin or whites of the eyes)

Charles M. Nolan, MD; Stefan V. Goldberg, MD; Susan E. Buskin, PhD;

Hepatotoxicity Associated With Isoniazid Preventive Therapy -

A 7-Year Survey From a Public Health Tuberculosis Clinic Vol. 281, pp.

1014-1018, Mar. 17, 1999

 

See also GI Consult: Drug Hepatotoxicity

 

The National Library of Medicine of the National Institutes of Health describes

the symptoms associated with liver toxicity in this way:

 

More common

Itching; skin rash

 

Less common

Aching of joints and muscles; difficulty in swallowing; pale skin; redness,

blistering, peeling, or loosening of skin; sore throat and fever; unusual

bleeding or bruising; unusual tiredness or weakness; yellow eyes or skin

 

Rare

Abdominal or stomach cramps and pain (severe); abdominal tenderness; blood in

urine; diarrhea (watery and severe), which may also be bloody; greatly

increased or decreased frequency of urination or amount of urine; increased

thirst; lower back pain; mood or mental changes; pain or burning while

urinating; swelling of front part of neck

 

Some of the above side effects (severe abdominal or stomach cramps and pain, and

watery and severe diarrhea, which may also be bloody) may also occur up to

several weeks after you stop taking any of these medicines.

 

 

 

 

 

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