Drug induced liver injury screening: Difference between revisions
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{{Drug induced liver injury}} | {{Drug induced liver injury}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{rachita}} | ||
==Overview== | ==Overview== | ||
General screening guidelines for drug induced liver injury do not exist. However, certain specific guidelines have been established for drugs associated with a high incidence of severe liver injury, e.g. methotrexate.<ref name="pmid7986233">{{cite journal| author=Fries JF, Ramey DR, Singh G| title=Suggested guidelines for monitoring liver toxicity in rheumatoid arthritis patients treated with methotrexate: comment on the article by Kremer et al. | journal=Arthritis Rheum | year= 1994 | volume= 37 | issue= 12 | pages= 1829-30 | pmid=7986233 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7986233 }} </ref> These guidelines remain controversial. | |||
==Screening== | ==Screening== | ||
Periodic screening of serum alanine aminotransferase is sometimes initiated for drugs associated with a high incidence of liver injury, at provider discretion.<ref name="pmid22541696">{{cite journal| author=Davern TJ| title=Drug-induced liver disease. | journal=Clin Liver Dis | year= 2012 | volume= 16 | issue= 2 | pages= 231-45 | pmid=22541696 | doi=10.1016/j.cld.2012.03.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22541696 }} </ref> | |||
However, because frequent laboratory monitoring is often not possible for both patients and providers, compliance with any drug-specific surveillance guidelines is variable and drug-specific guidelines remain controversial. This is largely because the significance of a mildly elevated serum alanine aminotransferase is unclear and may result in inappropriate drug withdrawal in patients who would otherwise adapt to ongoing use of the inciting drug. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 20:38, 24 October 2016
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Drug induced liver injury Microchapters |
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Differentiating Drug Induced Liver Injury from other Diseases |
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Diagnosis |
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Treatment |
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Drug Induced Liver Injury On the Web |
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American Roentgen Ray Society Images of Drug induced liver injury |
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Risk calculators and risk factors for Drug induced liver injury |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rachita Navara, M.D. [2]
Overview
General screening guidelines for drug induced liver injury do not exist. However, certain specific guidelines have been established for drugs associated with a high incidence of severe liver injury, e.g. methotrexate.[1] These guidelines remain controversial.
Screening
Periodic screening of serum alanine aminotransferase is sometimes initiated for drugs associated with a high incidence of liver injury, at provider discretion.[2]
However, because frequent laboratory monitoring is often not possible for both patients and providers, compliance with any drug-specific surveillance guidelines is variable and drug-specific guidelines remain controversial. This is largely because the significance of a mildly elevated serum alanine aminotransferase is unclear and may result in inappropriate drug withdrawal in patients who would otherwise adapt to ongoing use of the inciting drug.
References
- ↑ Fries JF, Ramey DR, Singh G (1994). "Suggested guidelines for monitoring liver toxicity in rheumatoid arthritis patients treated with methotrexate: comment on the article by Kremer et al". Arthritis Rheum. 37 (12): 1829–30. PMID 7986233.
- ↑ Davern TJ (2012). "Drug-induced liver disease". Clin Liver Dis. 16 (2): 231–45. doi:10.1016/j.cld.2012.03.002. PMID 22541696.