Drug Induced Liver Injury Flashcards

1
Q

True or False? Hepatic drug reactions are rare in children

A

True

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2
Q

Elderly are at an increased risk for hepatic drug reactions. What are 3 reasons why?

A

Elderly have decreased clearance, decreased hepatic blood flow, and possible drug-drug interactions due to having more medications

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3
Q

True or False? Females are at a decreased risk of hepatic drug reactions

A

False. They are at an increased risk

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4
Q

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

A

14

7

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5
Q

What are biomarkers that may be increased which indicate a drug induced liver injury

A

AST, ALT, alkaline phosphate

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6
Q

Besides increased biomarkers, what are two other methods that drug induced liver injury can be diagnosed

A

Liver biopsy or ultrasound

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7
Q

What are 3 drugs that are intrinsic hepatotoxins?

A

Acetaminophen, iron, ethanol

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8
Q

How long do intrinsic hepatotoxins stay in your body?

A

They have brief latency. Hours to days

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9
Q

What are 5 examples of drugs that cause immune-mediated idiosyncratic reactions?

A

Sulfonamides, phenytoin, allopurinol, augmentin, abacavir

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10
Q

What are adverse effects seen in drugs that cause immune-mediated idiosyncratic reactions?

A

Rash, fever, joint pain

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11
Q

How long is the onset of drugs that cause immune-mediated idiosyncratic reactions?

A

Delayed onset. 1-5 weeks

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12
Q

What are 5 examples of drugs that cause nonimmune-mediated idiosyncratic reactions?

A

Isoniazid, ketoconazole, amiodarone, phenytoin, valproic acid

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13
Q

How long is the onset of drugs that cause nonimmune-mediated idiosyncratic reactions?

A

Variable onset. Weeks to months

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14
Q

HIV medications are metabolized via the CYP___ pathway

A

CYP3A4

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15
Q

True or False? Statins cause asymptomatic liver injury

A

True

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16
Q

___ is a drug indicated for tuberculosis which has a BBW for hepatitis within 3 months of therapy

A

Isoniazid

17
Q

___ has a BBW for hepatic failure in children, which leads to death

A

Valproic acid

18
Q

What drug is used to treat valproic acid-induced hepatic failure in children?

A

Carnitine

19
Q

___ is the #1 cause of liver failure

A

Acetaminophen

20
Q

True or False? Children are more susceptible to acetaminophen-induced liver failure than adults

A

False. Children are more resistant

21
Q

Acetaminophen overdose causes depletion of ___ which causes an accumulation of ___, a toxic metabollite

A

Glutathione (renally excreted)

NAPQI