Liver; Chemical & Drug Injury

Question 1

Inorganic compounds producing hepatoxicity

Answer 1

• Arsenic
• Phosphorus
• Copper
• Iron

Question 2

Organic agents producing hepatoxicity

Answer 2

• Pyrrolizidine alkaloids
• Mycotoxins
• Bacterial toxins

Question 3

Direct or Predictable hepatotoxicity

Answer 3

Direct or predictable, when the drug or one of its metabolites is either directly toxic to the liver or it lowers the host immune defense mechanism.

The adverse effects occur in most individuals who consume them and their hepatotoxicity is dose-dependent e.g. carbon tetrachloride.

Question 4

Indirect or unpredictable or idiosyncratic hepatotoxicity

Answer 4

• Indirect or unpredictable or idiosyncratic, when the drug or one of its metabolites acts as a hapten and induces hypersensitivity in the host.
• In many instances, drug hepatotoxicity is associated with appearance of autoantibodies to liver-kidney microsomes (i.e. anti-LKM2) directed against cytochrome P450 enzyme.