Drug induced liver injury medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
It has been hypothesized that early drug withdrawal prevents progression to acute liver failure, but there is insufficient data to support this, as sometimes even a few days of exposure to a drug can cause a fatal outcome. | The mainstay of therapy for drug induced liver injury is prompt withdrawal of the offending drug. It has been hypothesized that early drug withdrawal prevents progression to [[acute liver failure]], but there is insufficient data to support this, as sometimes even a few days of exposure to a drug can cause a fatal outcome. | ||
There | There are no FDA approved antidotes for idiosyncratic drug induced liver injury. N-acetylcysteine has only been approved for [[acetaminophen]]-induced liver injury.<ref name="pmid24935270">{{cite journal| author=Chalasani NP, Hayashi PH, Bonkovsky HL, Navarro VJ, Lee WM, Fontana RJ et al.| title=ACG Clinical Guideline: the diagnosis and management of idiosyncratic drug-induced liver injury. | journal=Am J Gastroenterol | year= 2014 | volume= 109 | issue= 7 | pages= 950-66; quiz 967 | pmid=24935270 | doi=10.1038/ajg.2014.131 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24935270 }} </ref> | ||
Corticosteroid therapy has also been proposed as treatment for acute liver failure resulting from drug induced liver injury. However, unlike for alcoholic and autoimmune hepatitis, there are no controlled trials to support this therapy for drug induced liver injury. | [[Corticosteroid]] therapy has also been proposed as treatment for [[acute liver failure]] resulting from drug induced liver injury. However, unlike for [[alcoholic hepatitis|alcoholic]] and [[autoimmune hepatitis]], there are no controlled trials to support this therapy for drug induced liver injury. | ||
Symptoms such as pruritis can be managed with | Symptoms such as [[pruritis]] can be managed with [[antihistamine]]s including [[hydroxyzine]] and [[diphenhydramine]]. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 19:41, 26 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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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
The mainstay of therapy for drug induced liver injury is prompt withdrawal of the offending drug.
Medical Therapy
The mainstay of therapy for drug induced liver injury is prompt withdrawal of the offending drug. It has been hypothesized that early drug withdrawal prevents progression to acute liver failure, but there is insufficient data to support this, as sometimes even a few days of exposure to a drug can cause a fatal outcome.
There are no FDA approved antidotes for idiosyncratic drug induced liver injury. N-acetylcysteine has only been approved for acetaminophen-induced liver injury.[1]
Corticosteroid therapy has also been proposed as treatment for acute liver failure resulting from drug induced liver injury. However, unlike for alcoholic and autoimmune hepatitis, there are no controlled trials to support this therapy for drug induced liver injury.
Symptoms such as pruritis can be managed with antihistamines including hydroxyzine and diphenhydramine.
References
- ↑ Chalasani NP, Hayashi PH, Bonkovsky HL, Navarro VJ, Lee WM, Fontana RJ; et al. (2014). "ACG Clinical Guideline: the diagnosis and management of idiosyncratic drug-induced liver injury". Am J Gastroenterol. 109 (7): 950–66, quiz 967. doi:10.1038/ajg.2014.131. PMID 24935270.