Review on drugs inducing hepatotoxicity

Author : Sidhi Sunil, Saerah Simon, Micah Susan Mathew, Renuka R, Elessy Abraham

Drug-induced liver injury is a frequent cause of hepatic dysfunction. Chemicals that cause liver injury are called Hepatotoxins. For establishing hepatotoxicity of a particular drug, exclusion of other plausible causes is needed prior. The pattern of liver test abnormality, duration of latency to symptomatic presentation, the presence or absence of immune-mediated hypersensitivity and the response to drug withdrawal are needed for establishing hepatotoxicity of a drug. The liver plays an astonishing array of vital functions in the maintenance and regulation of body homeostasis. The major functions of the liver are carbohydrate, protein and fat metabolism, detoxification, secretion of bile and storage of vitamin. Liver is involved with almost all the biochemical pathways to growth, fight against disease, nutrient supply, energy provision and reproduction. Thus, maintenance of healthy liver is a crucial factor for the overall health and wellbeing. Certain medicinal agents, when taken in overdoses and sometimes even when introduced within therapeutic ranges, may injure liver. Other chemical agents, such as those used in laboratories and industries, natural chemicals and herbal remedies can also induce hepatotoxicity. More than 900 drugs have been implicated in causing liver injury and it is the most common reason for a drug to be withdrawn from the market. Chemicals often cause subclinical injury to liver which manifests only as abnormal liver enzyme tests. Drug induced liver injury is responsible for 5% of all hospital admissions and 50% of all acute liver failures.

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