n CME : Your SA Journal of CPD - Drug-induced liver disease : main article

Volume 23, Issue 8
  • ISSN : 0256-2170



Drug-induced liver disease is common in clinical practice, accounting for between 6% and 70% of adverse and lethal drug reactions. <br>Some drugs that injure the liver do so in a predictable, dose-dependent manner. <br>Other drug-induced liver injury is peculiar to the individual and is called idiosyncratic or allergic. <br>Drug-induced liver disease may be an incidental finding on routine monitoring of liver function, or may present as frank liver disease. <br>Evaluation of drug-induced liver disease requires that the following questions be asked:<ul> <li>Can a causal relationship be established between the use of a drug and abnormal liver functions? </li> <li>Is underlying liver disease present? </li> <li>How sick is the patient? </li> <li>Can the pattern of enzyme abnormalities help predict the mode of injury and the most likely offending drug?&lt;/li&gt; <li>When is a liver biopsy indicated?</li></ul> Drug-induced liver disease is usually treated by stopping the drug. <br>In some cases, where no other liver disease is present and the enzyme derangement is mild, liver function can simply be monitored without stopping the drug. <br>Drugs that are most commonly implicated in drug-induced liver disease in South Africa are NSAIDs, certain antibiotics and methotrexate.

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