Jaundice cholestatic

The term cholestatic jaundice is used to include all cases of extrahepatic obstructive jaundice. It also covers those cases of jaundice that exhibit conjugated hyperbilirubinemia due to micro-obstruction of intrahepatic biliary ductules by swollen, damaged hepatocytes (eg, as may occur in infectious hepatitis). 

Androgens Fluoxymesterone 10 mg orally twice a day Deepening voice, alopecia, hirsutism, facial/truncal acne, fluid retention, menstrual irregularities, cholestatic jaundice... 

Cholestatic jaundice of pregnancy Irregular or heavy vaginal bleeding severe dysmenorrhea... 

Taggart, H., Fatal cholestatic jaundice in elderly patients taking benoxaprofen, Br. Med. /., 284, 1372,1982. 

Hepatic Nicotinic acid hepatotoxicity (including cholestatic jaundice) has occurred. Cases of severe hepatic toxicity, including fulminant hepatic necrosis, have occurred in patients who have substituted sustained-release nicotinic acid products for immediate-release nicotinic acid at equivalent doses. Monitor ALT prior to treatment, every 6 to 12 weeks during the first year, and periodically thereafter (approximately 6-month intervals). 

Long-term experience Long-term experience with danazol is limited. Long-term therapy with other steroids alkylated at the 17 position has been associated with serious toxicity (cholestatic jaundice, peliosis hepatitis). Similar toxicity may develop after long-term danazol. 

Phenothiazines Use phenothiazines with caution in patients with cardiovascular disease, liver dysfunction, or ulcer disease. Promethazine has been associated with cholestatic jaundice. 

Adverse reactions include the following Hypotension palpitations tachycardia drowsiness restlessness excitation nervousness insomnia euphoria blurred vision diplopia vertigo tinnitus auditory and visual hallucinations (particularly when dosage recommendations are exceeded) urticaria rash dry mouth anorexia nausea vomiting diarrhea constipation cholestatic jaundice (cyclizine) urinary frequency difficult urination urinary retention dry nose and throat. 

Hepatic reactions Hepatic reactions, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic necrosis, occur rarely. 

Hepatic Cholestatic jaundice, chronic active hepatitis, hepatic necrosis, hepatic reactions, hepatitis (rare). 

Adverse effects occur in 3-12% in the form of rash, fever, urticaria, vasculitis, arthralgia, a lupuslike reaction, cholestatic jaundice, hepatitis, lym-phadenopathy and polyserositis but the most dangerous adverse effect is agranulocytosis (it occurs only in 0.3-0.6%). The reaction is readily reversible when the drug is discontinued. Cross-sensitivity between propylthiouracil and methimazole is about 50%, therefore switching drugs in patients with severe reactions is not recommended. 

Cholestatic jaundice is observed infrequently, usually during the first few weeks of treatment. This is thought to be a hypersensitivity reaction and is usually mild and self-limited. Cutaneous allergic reactions are occasionally reported. Both types of problems normally disappear upon changing to an antipsychotic from a different chemical class. Photosensitivity usually manifests as an acute hypersensitivity reaction to sun with sunburn or rash, but the condition is generally mild and does not require dosage adjustment. 

Adverse effects that are not unequivocally related to inhibition of prostaglandin synthesis include hepatic effects (hepatitis, hepatic necrosis, cholestatic jaundice, increased serum aminotransferases), dermal effects (photosensitivities, Stevens-Johnson syndrome, toxic epidermal necrolysis, onycholysis), central nervous system (CNS) effects (headaches, dizziness, tinnitus, deafness, drowsiness, confusion, nervousness, increased sweating, aseptic meningitis), ocular effects (toxic amblyopia, retinal disturbances), and certain renal effects (acute interstitial nephritis, acute papillary necrosis). 

Allergic reactions (e.g., rashes, urticaria, and eosino-philia) have been observed. These drugs have occasionally been associated with cholestatic jaundice, blood dyscrasias, hemolytic anemia, hypoglycemia, and nephrotoxicity. Recently the use of ciprofloxacin for prophylaxis protection against anthrax infection has been associated with damage to muscle ligaments. 

Blood dyscrasias and cholestatic jaundice occur rarely. 

Signs and symptoms of gold toxicity, the primary serious reaction, include decreased Hgb level, decreased granulocyte count (less than 150,000/mm ), proteinuria, hematuria, stomatitis, blood dyscrasias (anemia, leukopenia WBC count less than 4000/mm, thrombocytopenia, and eosinophilia), glomerulonephritis, nephrotic syndrome, and cholestatic jaundice. 

Cholestatic jaundice, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis, and aplastic or hemolytic anemia occur rarely. 

Cholestatic jaundice, hepatocellular neoplasms, peliosis hepatis, edema with or without congestive heart failure, and suppression of clotting factors II, V, VII, andX have been reported. 

Rash, cholestatic jaundice, priapism Serious Reactions... 

---