As the saying goes, it is a medicine that is three points of poison. The serious adverse reactions caused by the drug are mainly reflected in the functional damage of the liver and kidneys. Because, after the drug enters the human body, the final metabolites need to be processed by the liver and kidneys. Globally, more than 1,100 chemically synthesized drugs have been found to be potentially hepatotoxic. The situation is even more serious here, because ordinary people have more access to medicines, and in some places, there are more pharmacies than public toilets. In addition, self-formulated drugs, blind use of folk remedies, abuse of health care products and other phenomena are also related factors leading to drug damage. So, which drugs are prone to liver damage? What manifestations can drug-induced liver injury cause? Who is easy to get caught and needs to strengthen prevention? Let's solve your doubts now.
Drug-induced liver injury, referred to as DILI, refers to liver injury induced by various chemical drugs, biological agents, traditional Chinese medicines, natural medicines, health care products, dietary supplements and metabolites, excipients, etc., and is the most common and serious adverse drug reaction. International studies have shown that the number of cases of DILI occurring in the current year per 100,000 people is about 13.9 to 19.1. Here, the incidence of drug-induced liver injury is an average of 23.8 cases per 100,000 people, acute DILI, accounting for about 20% of the proportion of hospitalizations for acute liver injury, of which 6% to 20% will develop chronic liver injury.
Drug-induced liver injury can be divided into hepatocyte injury type, cholestatic type, hepatic vascular injury type, mixed type and other types. With 1 drug, it can cause different types of liver damage. Different drugs can cause the same type of liver damage. Drug-induced liver injury can have no symptoms, only elevated biochemical indicators, and may also appear hepatitis, liver fibrosis, cirrhosis, liver failure, and even life-threatening.
When drug-induced liver injury occurs, there may be fatigue, loss of appetite, nausea, nasty greasiness, dark yellow or brown urine, abdominal distension, liver discomfort, and fever, rash, black stool, coma, etc. may also appear. To determine the relationship between drugs and liver injury, it is necessary to apply a causal relationship assessment scale, considering the time of taking and stopping the drug to liver injury, the change of liver function indicators after drug discontinuation, and the investigation of the cause of liver injury.
Usually, about 1 month after taking the drug, drug-induced liver damage is prone to occur, but it is also possible to develop liver damage after a few months of taking the drug, or even 1 year later. Therefore, when there is an unexplained liver injury manifestation or abnormal liver function index, the possibility of drug-induced liver injury should be considered, and when visiting the doctor, it is necessary to explain to the doctor in detail about his medication and carry out relevant examinations, so that it is possible to find drug-induced liver injury in time and take countermeasures.
The drug causes liver damage, which is divided into 2 cases. The first is that the drug directly damages the liver, which is mostly caused by overdose, or the drug is not paid attention to before taking the drug, and the potential impact of the drug on the liver is not clear, especially in patients with liver disease, because the relationship between the drug and their own condition is ignored, resulting in or aggravated liver damage. The second is specific liver toxicity caused by the immune system. This situation, which is usually difficult to predict, because after taking the drug, the immune response is triggered, and the immune cells attack the liver, resulting in drug-induced liver damage, which is more serious, rapidly progressing, and even life-threatening.
Drugs that cause liver damage, most notably, are nonsteroidal anti-inflammatory drugs, of which drug-induced liver damage caused by acetaminophen is particularly prominent. Here, drug-induced liver damage caused by anti-tuberculosis drugs is the most common and the most harmful adverse drug reaction. Anti-infective drugs such as clindamycin, antitumor drugs such as cyclophosphamide, drugs for the central nervous system such as carmaxipine, drugs for the cardiovascular system such as captopril, and hormone drugs such as methotimidazole and hexenstil for the treatment of metabolic diseases are common varieties that are prone to cause drug-induced liver damage. It is worth noting that here, the proportion of drug-induced liver damage caused by Chinese herbal medicines and dietary supplements accounts for more than 25%.
People who are prone to drug-induced liver damage, including the elderly, children, pregnant women, people who drink alcohol for a long time, people with liver disease, for example, pregnant women are susceptible to prothiopyrimidine and antibiotics, and when taking these drugs, they are prone to drug-induced liver damage. People who drink alcohol, taking drugs such as paracetamol and isoniazid may cause liver damage. In addition, drug-induced liver injury is also affected by genetic and gender factors, for example, women may show a higher susceptibility to minocycline, methyldopa, etc. Drug-induced liver injury can be acute onset or insidious, so liver function tests should be performed while taking medication in high-risk groups. In the event of a drug-induced injury, the pros and cons need to be weighed and the doctor decides whether to stop the drug immediately. In some cases, protective treatment should be carried out in a timely manner according to the results of liver function tests, so as to promote the regeneration of liver cells and enhance the detoxification ability of the liver. Finally, remind everyone that you should take medication according to the condition, need to understand the adverse reactions that the drug may bring before taking the drug, take the drug for a long time, and check the liver function regularly.
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