Drug hepatic disease (Drug-Induced Liver Injury, DILI) refers to toxic damage to the liver caused by drugs and their metabolic products, which may cause abnormal and even severe liver damage. The following is a study of concepts, causes, symptoms, prevention and treatment, with the aim of helping to understand and prevent drug hepatitis.
I. What is pharmaceutical liver disease?
When a drug enters the body, it is required to undergo liver metabolism and detoxification. However, some drugs or their metabolites are directly toxic to hepatocellular cells or cause immunogenic damage, leading to liver dysfunction. This drug-induced liver injury is a drug-based liver disease.
Drug hepatitis is one of the most common drug adverse effects and an important cause of liver failure.
II. Common pathogens
Common drugs
Antithermal analgesics: e.g. acetylaminophenol (polymeric pain).
Antibiotics: e.g. erythrin, tetracyclic, chlorcin.
Anti-tuberculosis drugs: e.g., amphibian, livoping, acetamine.
Inflammatory drugs (NSAIDs): e.g. Brophine, micin.
Anti-tumour drugs: e.g., aminophosphate, cyclophosphate.
Chinese herbs and health products: e.g., herbs containing safrole, reeds or horse bellicose acid.
Risk factors
Drug dose: Excessive use of drugs increases the risk of liver damage (e.g. overdose of acetylaminophenol).
Individual differences: Certain persons are more vulnerable to specific drugs because of genetic or immune factors.
Basic diseases: Persons with chronic liver disease or incomplete liver function are more vulnerable to drug abuse.
III. Symptoms of pharmaceutical liver disease
Symptoms of pharmaceutical liver disease are diverse, and light persons may not have visible symptoms, and acute liver failure may occur in heavy persons.
Early symptoms
Weaknesses, appetites, vomiting.
Right upper abdominal discomfort or pain.
Hepatic abnormalities (detected through medical or blood tests).
2. Serious symptoms
Yellow (skin, membrane yellow).
The urine color deepens and the shit color becomes light.
Abdominal swelling, confusion or coma (indication of liver failure).
IV. How to diagnose pharmaceutical hepatitis?
1. Medical history collection
Detailed information on recent drug use, including prescription, non-prescription, Chinese herbs and health products.
Laboratory inspection
Hepatic function check: Indicators such as ALT, AST, total chlamydia have increased.
Other liver diseases are excluded: viral hepatitis, alcoholic hepatitis, fat liver, etc.
3. Visual inspection
Hepatic damage due to other causes is excluded.
4. Drug recusal tests
Discontinuation of skeptical drugs is followed by an improvement in symptoms and liver function.
V. Preventive measures against drug hepatitis
1. Strict compliance with medical prescriptions
Avoid unauthorized increases in the dose of drugs or the use of combinations of drugs.
Special attention was paid to the doses and lifetimes of antithermal painkillers, antibiotics and anti-tuberculosis drugs.
2. Careful use of Chinese herbs and health products
Not to use herbal and health products of unknown origin or not scientifically proven, especially those containing horse-bellic acid.
3. Regular monitoring of liver functions
Long-term drug users (e.g., anti-tuberculosis drugs, chemotherapy drugs) should regularly check their liver function to detect problems in a timely manner.
4. Attention to high-risk populations
People with chronic hepatitis, the elderly, children and pregnant women are more likely to suffer from drug-related liver disease, with special care being taken.
Avoiding the simultaneous use of multiple drugs
The possible interaction of drugs increases the liver burden.
VI. Treatment of pharmaceutical liver diseases
1. Discontinuation of suspicious drugs
Detoxification is the most critical measure to reverse liver damage at an early stage.
2. Treatment of illness
Patients with mild disorders usually do not require special treatment and the liver function is gradually restored after the withdrawal.
Severely ill patients may need liver-protective drugs such as lysergic acid formulations or co-hepata.
3. Treatment of liver failure
Severe cases may require liver transplants.
4. Rescue from poisoning
An antidote (e.g. N-acetylene semi-screene) can be used for hepatic damage due to excess acetaminophenol.
VII. Misdirection of pharmaceutical liver disease
1. Error zone: Chinese herbs are safe
In practice, some of the herbs may contain components toxic to the liver and require careful use.
Error zone: no liver damage without symptoms
Early pharmaceutical liver disease may not have visible symptoms, but liver function may have been impaired and require periodic examination.
3. Misdemeanour: Hepatic damage will definitely improve after the stoppage
In some cases, there is a possibility of continued progress after the end of the drug hepatitis, requiring periodic review of liver function.
Summary
Medicinal liver disease is a preventable liver damage. Drug abuse, Chinese herbal medicine and health-care products are key to prevention, in strict compliance with medical guidance. Early detection and timely treatment can effectively reverse liver damage and reduce the risk of serious complications. If hepatic damage due to discomfort or suspicion of medication occurs, medical treatment should be provided as soon as possible and a detailed history of the use should be provided. Through scientific medicine and health management, we can better protect liver health.
Drug hepatitis
