DILI: Drugs Implicated in DILI, DILIN, Spanish Registry Data

Question 1

Top cause of DILI

Answer 1

APAP

Question 2

Top cause of DILI that’s not APAP

Answer 2

amox/clav

Question 3

What’s amox/clav known to cause?

Answer 3

Cholestatic jaundice

Question 4

Symptom onset of amox/clav DILI

Answer 4

2-45 days after ingestion

Question 5

Management of amox/clav DILI

Answer 5

supportive care, will self-resolve

Question 6

DILIN study: drug classes most implicated with DILI

Answer 6

ABX, herbal and dietary supplements, CV agents, CNS agents, antineoplastics, analgesics, immunomodulatory, endocrine, rheumatologic, GI

Question 7

What was associated with higher mortality rates from the DILIN trial?

Answer 7

Total bili >2.5mg/dl

Question 8

Amox/clav is associated with what HLA allele?

Answer 8

HLA-DRB1*15 allele

Question 9

DILIN: drug class that had short latency

Answer 9

quinolones

Question 10

DILIN: drug that had long latency

Answer 10

nitrofurantoin

Question 11

DILIN: drugs implicated for DILI

Answer 11

Amox/clav, isoniazid, nitrofurantoin, Bactrim, minocycline, cefazoline, azithromycin, ciprofloxacin, levofloxacin, PO diclofenac

Question 12

Spanish Registry Data: patients with what had worse outcomes?

Answer 12

jaundice

Question 13

Spanish Registry Data: drug classes that were the most implicated

Answer 13

ABX, CNS agents, musculoskeletal, GI

Question 14

DILIN: patients with what type of DILI had the best outcomes

Answer 14

Mixed injury

Question 15

DILIN: patients with what type of DILI had the worst outcomes

Answer 15

Hepatocellular

Question 16

DILIN: which patient population were more likely to have cholestatic injury

Answer 16

Elderly

Question 17

Rechallenging drugs after a DILI: when can it be considered?

Answer 17

If the patient had ONLY cholestatic injury

Question 18

Rechallenging drugs after a DILI: when should it NOT be considered?

Answer 18

If the patient had HEPATOCELLULAR injury

Question 19

In general, should you rechallenge a drug after a DILI>

Answer 19

No, unless no alternative exists for it