Drug Induced Liver Disease & Acetaminophen Toxicity

by Carlo Raj, MD

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    Drug Induced Liver Disease In pharmacology, you have learned a huge list of those drugs that are Hepato toxic You've also learned about those drugs that inhibit or stimulate cytochrome P450 5% of all adverse drug reactions are actually hepatic. Do you see what that statement says? 5% of all adverse drug reactions are hepato toxic. liver function tests becomes extremely important for you. accounts for 20 to 30% of fulminant liver failure. This is no joke. And once I get past the general introduction, of drug induced liver disease, I will focus upon Acetaminophen and make sure that you are absolutely clear about how severe and dangerous this is. Reactions can be dose-dependent and/or Idiosyncratic And the problem is the fact is, often times, when the drugs have been taken The patient might not even present with symptoms and that is scary You really need to make sure that you take a proper history Psychological evaluation is absolutely important or psychiatric evaluation We will talk about that in a second. Injury resolves with removal of offending drug The problem with that is the fact that when you remove the offending drug, because it might caused so much damage to your liver, What's the repair process called? The repair process is called fibrosis. So you might actually have an increased amount of fibrosis. depositing the liver, ugh, and might actually look rather Cirrhotic. Transplantation for fulminant liver failure. our focus acetaminophen toxicity is important. It is often times, the number one cause of liver transplantation in the young. earlier, when I was talking to you about drug-induced type of liver disease, I told you that I would have you focused on Acetaminophen and secondly, I told you that psychiatric evaluation is important. Imagine that you have a patient, a young...

    About the Lecture

    The lecture Drug Induced Liver Disease & Acetaminophen Toxicity by Carlo Raj, MD is from the course Cirrhosis – Liver Diseases.

    Included Quiz Questions

    1. More than 4 grams per day
    2. More than 3 grams per day
    3. More than 2 grams per day
    4. More than 5 grams per day
    5. More than 6 grams per day
    1. Zone 3
    2. Zone 2
    3. Zone 1
    4. Zone 4
    5. Central vein
    1. CYP2E1
    2. CYP A3
    3. CYP B
    4. CYP C
    5. CYPB6

    Author of lecture Drug Induced Liver Disease & Acetaminophen Toxicity

     Carlo Raj, MD

    Carlo Raj, MD

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    What about other drugs?
    By Hamed S. on 15. March 2017 for Drug Induced Liver Disease & Acetaminophen Toxicity

    It would have been great to list the most common agents that could potentially lead to liver toxicity aside from paracetamol, incl phenytoin, statins, amiodarone, methotrexate. Also not sure if this would be discussed in the Emergency Medicine talks but actually working up the patient and what to do from a monitoring point of view once a diagnosis of paracetamol overdose would have been really helpful. It would have been worth noting that acetylcysteine most efficacious within 8 to 10 hours after ingestion of paracetamol.