Hepatic damage drugs involved

Halothane is a very widely used anesthetic drug, which may cause hepatic damage in some patients. It seems that there are two types of hepatic damage, however. One is a very rare reaction, idiosyncratic, resulting in serious liver damage with an incidence of about 1 in 35,000. The other form of hepatotoxicity is a mild liver dysfunction, which is more common and occurs in as many as 20% of patients receiving the drug. The two different types probably involve different mechanisms. 

Halothane. Anaesthetic drug which causes hepatic damage. Mild hepatic dysfunction is common. Occasionally serious hepatic necrosis occurs which is an idiosyncratic reaction (factors multiple exposures sex—female> male obesity history of allergy). A reactive metabolite is produced which binds to hepatocyte protein (microsomal) and stimulates an immunological reaction involving T-lymphocytes and antibodies (Antibody-Dependent Cell Cytotoxicity). Hepatocytes are destroyed by lymphocyte-mediated cytolysis. 

Table 10. Drugs frequently involved in hepatic damage. (Adapted from van Arsdel 1978 Parker 1980)...

Halothane-induced hepatitis that occurs in the postoperative period most often is due to transmission of hepatitis virus (e.g., in transfused blood), involvement of the liver by disease processes, or damage by known hepatotoxic drugs. Hepatic necrosis, although rare, does occur with halothane. 

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