Drug-Induced Liver Disease

The liver is the organ that is responsible for a variety of functions of the human body, including removal of toxins and filtration of waste products. The liver has many enzymes that aid in  drug  metabolism. With increasing use of various  drugs ,  drug-induced  liver disease has become quite common. Symptoms may or may not be similar to other liver diseases. When the symptoms are similar, it becomes difficult to understand whether the symptoms have been caused by disease or  drugs .  Drug-induced  liver disease can be classified as predictable and unpredictable.

Predictable  Drug-induced  Liver Disease

Intrinsic  drug  reactions can cause liver damage. Predictable  drug-induced  liver disease is related to the dosage of  drugs  that cause liver injury. Certain  drugs , when taken in excessive amounts, have toxic effects on the liver. This kind of liver disease can be treated easily upon careful examination of the patient’s  drug  history. Toxic doses of acetaminophen that result in hepatocellular necrosis is the most frequently recorded case of  drug  induced liver failure. Other  drugs  that cause different liver diseases are amiodarone, bromfenac, tetracycline, niacin, cyclosporine, and certain oral contraceptives.

Unpredictable  Drug-induced  Liver Disease.

Idiosyncratic  drug  reactions can cause liver injury. This type of  drug  reaction occurs mostly in persons who cannot tolerate a particular  drug . Use of one particular  drug  may cause liver disease only in a fraction of individuals. It is not related to dosage, i.e., even small amounts of the  drug  can cause adverse reactions and are usually due to some genetic disorder. Enzymes required to metabolize certain  drugs  may not be present in liver cells causing damage to the liver. Isoniazid and diclofenac may cause hepatocellular necrosis.  Drugs  like chlorpromazine and estrogen may cause cholestasis. Use of certain oral contraceptives and anabolic steroids may result in hepatic or liver tumor.

Toxicity of the  drug  administered is determined and methods are then adopted to detoxify the patients suffering from  drug  induced liver disease.