Drug induced liver disease Flashcards
what is the value of a RUQ US?
rule out gallstone and/or dilated ducts
what antibodies can be tested to rule out autoimmune liver disease?
AMA
ASMA
ANA
LKM
what drug class is the most common cause of DILI? which drug specifically?
abx
augmentin
when does the onset of DILI occur?
2-6 weeks
how is DILI measured by liver markers?
bilirubin ALP AST (SGOT) ALT (SGPT) GGT
acetaminophen causes what general type of DILI?
intrinsic
what is the most common cause of withdrawal of an approved FDA drug from the market?
DILI
what are the three components of Hy’s law?
- serum ALT or AST greater than 3x ULN
- serum total bili elevated more than 2x ULN without initial findings of cholestasis
- nothing else explains elevated liver enzymes
what does the FDA use to initiate close investigation of patients with elevated liver tests?
Hy’s law
what is the most common cause of acute liver failure and transplantation in the western countries?
DILI
what are the DILI risk factors?
age gender obesity drug exposure (etoh) history of previous drug reactions
what agent is the leading cause of acute liver failure in the US?
acetaminophen
how much acetaminophen can an adult take in 24h?
4g
what is the toxic metabolite of acetaminophen metabolism?
NAPQI
what are the metabolic fates of NAPQI? which enzymes/process are responsible?
mercapturic acid - GSH
necrosis - covalent binding
