Drug induced liver injury screening: Difference between revisions
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==Overview== | ==Overview== | ||
General screening guidelines for drug induced liver injury do not exist. | General screening guidelines for drug induced liver injury do not exist. However, certain specific guidelines have been established for drugs associated with severe 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> | ||
==Screening== | ==Screening== | ||
Revision as of 22:52, 10 August 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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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 severe injury, e.g. methotrexate.[1]
Screening
Periodic screening of serum alanine aminotransferase is sometimes initiated for drugs that are specifically associated with liver injury, at provider discretion.[2] An open access database of over 600 drugs implicated in liver injury can be found at http://livertox.nih.gov/.
However, because frequent laboratory monitoring is often not possible for both patients and providers, compliance with any drug-specific surveillance guidelines is variable. In addition, 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.