Drug Induced Liver Injury Flashcards
True or False? Hepatic drug reactions are rare in children
True
Elderly are at an increased risk for hepatic drug reactions. What are 3 reasons why?
Elderly have decreased clearance, decreased hepatic blood flow, and possible drug-drug interactions due to having more medications
True or False? Females are at a decreased risk of hepatic drug reactions
False. They are at an increased risk
To assess causality of hepatic drug reactions, a ___ point scale is used. A score of < ___ means that there is a decreased likelihood that the drug caused the problem
14
7
What are biomarkers that may be increased which indicate a drug induced liver injury
AST, ALT, alkaline phosphate
Besides increased biomarkers, what are two other methods that drug induced liver injury can be diagnosed
Liver biopsy or ultrasound
What are 3 drugs that are intrinsic hepatotoxins?
Acetaminophen, iron, ethanol
How long do intrinsic hepatotoxins stay in your body?
They have brief latency. Hours to days
What are 5 examples of drugs that cause immune-mediated idiosyncratic reactions?
Sulfonamides, phenytoin, allopurinol, augmentin, abacavir
What are adverse effects seen in drugs that cause immune-mediated idiosyncratic reactions?
Rash, fever, joint pain
How long is the onset of drugs that cause immune-mediated idiosyncratic reactions?
Delayed onset. 1-5 weeks
What are 5 examples of drugs that cause nonimmune-mediated idiosyncratic reactions?
Isoniazid, ketoconazole, amiodarone, phenytoin, valproic acid
How long is the onset of drugs that cause nonimmune-mediated idiosyncratic reactions?
Variable onset. Weeks to months
HIV medications are metabolized via the CYP___ pathway
CYP3A4
True or False? Statins cause asymptomatic liver injury
True
___ is a drug indicated for tuberculosis which has a BBW for hepatitis within 3 months of therapy
Isoniazid
___ has a BBW for hepatic failure in children, which leads to death
Valproic acid
What drug is used to treat valproic acid-induced hepatic failure in children?
Carnitine
___ is the #1 cause of liver failure
Acetaminophen
True or False? Children are more susceptible to acetaminophen-induced liver failure than adults
False. Children are more resistant
Acetaminophen overdose causes depletion of ___ which causes an accumulation of ___, a toxic metabollite
Glutathione (renally excreted)
NAPQI
