DILI Flashcards
0
Q
Alcohol
A
- direct hepatotoxin
- AST higher than ALT
- high GGTP
- increases lipid biosynthesis
- decreases AMP dependent protein kinase which breaks down lipids
- therefore, leads to steatosis and then subsequent hepatic fibrosis and cirrhosis
- increases gut permeability allowing bacterial endotoxins to enter the bloodstream and liver
- activation of immune system leading to steatosis and Kuppfer cell activation, thus causing release of inflammatory cytokines and subsequent liver fibrosis and damage
- also inactivates natural killer cells (NK cells)
1
Q
Acetaminophen
A
- hepatocellular damage
- increased AST/ALT
- detoxified with glucuronidation, sulfation, and GSH conjugation
- toxic NAPQI formed by phase 1 hydroxylation
- NAPQI becomes toxic when combined with hepatocyte proteins
2
Q
Chlorpromazine
A
- cholestasis
- increased alk phos and deepening jaundice with prolonged course
3
Q
Erythromycin
A
- cholestasis
- increased alk phos and deepening jaundice with prolonged course
4
Q
Nitrofurantoin
A
- chronic hepatitis
- mild increase in ALT/AST
5
Q
Sulfonamides
A
-mixed pattern of hepatocellular damage and cholestasis
6
Q
Methotrexate
A
-fibrosis
7
Q
Amiodarone
A
-NASH
8
Q
Tamoxifen
A
-NASH
9
Q
Busulfan
A
-veno-occlusive
10
Q
Hepatocellular Damage
A
-higher mortality
11
Q
Cholestasis
A
- chronic
- less ominous
12
Q
Isoniazid
A
-acute hepatitis
13
Q
Diclofenac
A
- chronic hepatitis
- mild increase in ALT/AST
14
Q
Statins
A
- chronic hepatitis
- mild increase in ALT/AST
