Cirrhosis drug-induced

Non-cholestatic cirrhosis (e.g., alcoholic cirrhosis, postnecrotic cirrhosis, and drug-induced cirrhosis)... 

Alkaline phosphatase levels and GGT are elevated in plasma with obstructive disorders that disrupt the flow of bile from hepatocytes to the bile ducts or from the biliary tree to the intestines in condition such as primary biliary cirrhosis, sclerosing cholangitis, drug-induced cholestasis, gallstone disease, and autoimmune cholestatic liver disease. 

Chemical injuries to the liver depend on the type of toxic agent, the severity of intoxication, and the type of exposure, whether acute or chronic. The six basic types of liver damage are fatty liver, necrois, hepatobiliary dysfuntions, viral-hke hepatitis, and (on chronic exposure) cirrhosis and neoplasia. A number of organic chemicals and drugs induce fatty liver and hver necrosis. 

A biopsy is often required to make a diagnosis of most types of liver disease. A specimen of liver can be used to identify fibrosis, cirrhosis, cholestasis and hepatitis, both acute and chronic, and tumours. Biochemical measurements can also be taken from a biopsy specimen to determine iron and copper content, virology, microbiology and haematology (e.g. increased numbers of eosinophils in a drug-induced cause). The biopsy can give an indication of the extent of the liver damage. See Chapter 3 for slides of liver biopsies. 

Chronic steatohepatitis reveals only slight elevations of IgA and IgG. A pronounced increase in IgA is usually suggestive of an alcoholic or drug-induced cause. Elevation of IgA and IgG are laboratory markers for the development of cirrhosis. 

Hepatic encephalopathy is a metabolic disorder characterized by a wide spectrum of neuropsychiatric dysfunction. It may occur as an acute syndrome in patients with acute hepatic failure from viral or drug-induced hepatitis or as a chronic syndrome associated with liver failure and cirrhosis. 

Drug-induced liver disease occurs as several different clinical presentations idiosyncratic reactions, allergic hepatitis, toxic hepatitis, chronic active toxic hepatitis, toxic cirrhosis, and liver vascular disorders. 

Quintero E, Gines P, Arroya V, Rimola A, Camps J, Gaya J, Guevara A, Rodamilans M, Rodes J. Sulindac reduces the urinary excretion of prostaglandins and impairs renal function in patients with cirrhosis and ascites. Nephron 1986 42 298-303. Rossert J. Drug-induced acute interstitial nephritis. Kidney Int 2001 60 804-817. 

Calcium-channel blockers for the treatment of hypertension Calcium products Cephalosporins Cerebroactive medications Chlamydial infections treatment of Cholinergic drugs uses in medicine Cholinergic-receptor-blocking agents uses of Cirrhosis treatment of Congestive heart failure treatment of Constipation drug-induced Corticosteroids uses for Crohn s disease treatment of Cytokines their actions... 

G4000SW+G3000SW. Sample serum of normal female (a), patients with liver cirrhosis (b), acute hepatitis (c), primary biliary cirrhosis (d), intrahepatic cholestasis (e) and drug induced injury (f). Elution positions and other HPLC conditions as in Fig. 14. 

Raja K, Thung SN, Fiel MI, Chang C. Drug-induced steatohepatitis leading to cirrhosis long-term toxicity of amiodarone use. Semin Liver Dis 2009 29(4) 423-8. 

Haematologic A case of recurrent neutropenia on a combination of paliperidone long-acting injection and oral risperidone in a 45-year-old male with schizophrenia, alcohol dependence and hepatitis C cirrhosis is reported [196 ]. It is postulated that as drug-induced neutropenia may be dose-related the combination and effectively the greater exposure to risperidone and paliperidone contributed to the development of the blood dyscrasia. 

Loss of blood glucose control When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a loss of control may occur. At such times, it may be necessary to discontinue the drug and give insulin. Disulfiram-like syncframe. A sulfonylurea-induced facial flushing or breathlessness reaction may occur when some sulfonylureas are administered with alcohol. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) Water retention and dilutional hyponatremia have occurred after administration of sulfonylureas to type 2 diabetes patients, especially those with CHF or hepatic cirrhosis. 

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