Pharmacology of Liver Toxicity Flashcards
What are the 6 proposed mechanisms for drug-induced liver injury?
Calcium disturbances, inhibition of the bile salt export pump, formation of reactive metabolites, formation of immunogenic antigens, cell apoptosis, inhibition of lipid metabolism
What is the most common classification for drug hepatotoxicity?
Idiosyncratic hepatotoxicity
What enzyme is most specific for liver injury?
Glutamate Dehydrogenase
In a hepatocellular injury pattern, these lab values are at least 5x the normal upper limit.
ALT or R (ALT/ALP)
True/False. Most cases of drug-induced liver injury progress rapidly to liver failure.
False. Most cases resolve completely and only a few cases progress.
According to recent studies, these two drugs are the most common causes of drug-included liver injury.
Amoxicillin-clavulanate, Isoniazid
What is the liver injury classification of acetaminophen and aspirin?
Direct hepatotoxicity
What mechanism of hepatocyte injury does Reye Syndrome exhibit?
Inhibition of mitochondrial function
What CYP450 enzymes are most implicated in the formation of reactive metabolites?
CYP2C9, CYP1A2, CYP3A4
Augmentin generally exhibits this pattern of drug-induced liver injury.
Cholestatic Pattern
Acetaminophen and isoniazid generally exhibit what pattern of drug-induced liver injury?
Hepatocellular injury pattern
This classification of hepatotoxicity is dose-dependent, predictable, and reproducible.
Direct hepatotoxicity
A mixed pattern of drug-induced liver injury typically presents with what lab values?
ALT/ALP (R) between 2-5
What are the three classifications of drug-induced liver injury?
Direct, idiosyncratic, and indirect
Most antibiotics belong to this classification of hepatotoxicity.
Idiosyncratic hepatotoxicity
What drugs generally cause indirect hepatotoxicity generally?
Antineoplastics, glucocorticoids
