Drug-induced liver injury
T.E. Polunina
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Drug-induced liver injury (DILI) is one of the most complex acute or chronic liver diseases that doctors have to deal with while working. According to many researchers, liver injury caused by the direct or indirect effects of drugs or their metabolites on the liver can be referred to DILI. DILI is more than 10% of all adverse reactions of the body associated with use of drugs. It is necessary to pay special attention to those DILI cases which imply the intake of various dietary supplement products (DSP) and traditional medicine. It is necessary to keep in mind the potential hepatotoxicity of these drugs, since even in developed countries the development of dietary supplements is not controlled as strictly as the process of entering the pharmaceuticals market. In particular, preclinical and clinical toxicology safety trials, clinical safety and efficacy trials are not necessary for their registration. Ademetionine 1,4-butanedisulfonate (Heptor) can be considered as the first-line hepatoprotective drugs for DILI. The article considers epidemiology, classification, algorithm for diagnosis and treatment of drug-induced liver injury. The system of differential diagnostics, the stages of diagnostics of drug-induced liver injury, the modern approaches to pharmacotherapy of drug-induced liver injury, the best options for drug treatment are given.
Key words: liver injury, hepatotoxic effect, acute hepatic failure, hepatocytes, necrosis, steatosis, cholestasis, drug idiosyncrasy, jaundice, hepatoprotectors, ademetionine, Heptor.
For citation: Polunina T.E. Drug-induced liver injury // RMJ. Medical Review. 2018. № 7(I). P. 7–12.
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