PhD, PharmaD. Prof. University of Antioquia. Clinical Pharmacy and Pharmacology, Department of Pharmacy, Faculty of Pharmaceutical and Food Sciences and Research Group on Pharmaceutical Promotion and Prevention, University of Antioquia, Colombia, and Research Group on Pharmaceutical Care, University of Granada, Granada, Spain
Part of the book: Understanding HIV/AIDS Management and Care
Hepatotoxicity is the injury or liver damage caused by exposure to drugs; it is an adverse drug reaction that may be uncommon but serious. The hepatic injury can be classified into hepatocellular, cholestatic and mixed, caused by increase in alanine aminotransferase and alkaline phosphatase than upper limit of normal. The risk factors include idiosyncrasy, age, gender, alcohol consumption, concomitant use of other drugs, previous or underlying liver disease, genetic and environmental factors. Liver toxicity manifestations are generally accompanied by nonspecific symptoms such as abdominal pain, jaundice, fever, nausea, vomiting, diarrhea, pruritus and rash. Identification of hepatotoxicity is a complex process to perform; therefore, clinical scales have been developed, such as the Roussel Uclaf Causality Assessment Method (CIOMS/RUCAM) and the Clinical Diagnostic Scale (M & V CDS). Additionally, there is no specific treatment for hepatotoxicity, which is based on suspending the suspected drug and treating symptoms. The most commonly associated pharmacological groups are antibiotics, nonsteroidal anti-inflammatory analgesics (NSAIDs), antidepressants and anticonvulsants. Drug-induced liver injury has been an adverse event, hard to identify, prevent and treat; thereby, the pharmacist intervention can contribute to the diminution of the deleterious effects in patient health.
Part of the book: Pharmacokinetics and Adverse Effects of Drugs