xxxxxx23. Drug induced liver injury xxxxxx

Question 1

what are the characteristics of direct hepatotoxics ?

Answer 1

dose dependant

characteristic change to liver most of all

such as paracetamol of more than 10g

Question 2

what are the characteristics of indirect hepatotoxic ?

Answer 2

non independent of the dose and unpredictable

affect only some people and varying degrees ofdaamge

distinguished into 4 types on 
1) cholestatic injury 
antibiotics, 
antidepressives, antidiabetics, 
antiepileptics, 
anticoagulants
duiretics,

hepatocellular injury mimic acute hepatitis 
 antibiotics,
antidiabetics, 
anticoagulants,  
antimycotics, 
malaria drugs,
narcotics

granuloma
Allopurinol, Diazepam, Halothane, Methyldopa,

tumor
oral contraceptives, anabolics

Question 3

what are the clinical findings in cholestatic injury ?

Answer 3

darkening of urine, bright stool, icterus, pruritus

Question 4

diagnosis of cholestatic injury ?

Answer 4

increase ALP, gamma-GT and bilirubin (transaminases not significantly increased)

Question 5

diagnosis of hepatocellular injury ?

Answer 5

▲transaminases , also ALP and gamma-GT

▼albumin

eosiniphilia