Hepatic failure/hepatotoxicity caused

A person s use of alternative medicine must be solicited. Many herbal remedies were once wisely abandoned because of their common adverse reactions. Comfrey tea is a common cause of hepatocellular damage. As in the case of the Chinese remedy jin bu huan, or as in the case of the more elegantly presented chaparral capsules containing grease wood leaves, the end of therapy with these types of agents is occasionally severe disability or death from fulminant hepatic failure." Pennyroyal oil, maragosa oil, and clove oil cause a dose-related hepatotoxicity." ... 

The most common serious side effects are hepatotoxicity, manifested as elevated serum transaminases and hyperglycemia Both regular (crystalline) niacin and sustained-release niacin have been reported to cause severe liver toxicity, and sustained-release niacin can cause fulminant hepatic failure. An extended-release niacin (NIASPAN), appears to be less likely to cause severe hepatotoxicity, perhaps because it is administered only once daily. The incidence of flushing and pruritus with this preparation is not substantially different from that with regular niacin. Severe hepatotoxicity is more likely to occur when patients take >2 g of sustained-release, over-the-counter preparations. Affected patients experience flu-like fatigue and weakness. Usually, serum transaminases are elevated serum albumin levels decline, and total cholesterol and LDL-C levels decline substantially. 

Acetaminophen causes few adverse reactions when used as directed on the label or recommended by the primary health care provider. Adverse reactions associated with the use of acetaminophen usually occur with chronic use or when the recommended dos e is exceeded. Adverse reactions to acetaminophen include skin eruptions, urticaria (hiv ), hemolytic anemia, pancytopenia (a reduction in all cellular components of the blood), hypoglycemia, jaundice (yellow discoloration of the sMn), hepatotoxicity (damage to tlie hver), and hepatic failure (seen in chronic alcoholics taking the drug). 

Hepatotoxicity Naltrexone has the capacity to cause direct hepatocellular injury when given in excessive doses. It is contraindicated in acute hepatitis or liver failure, and its use in patients with active liver disease must be carefully considered in light of its hepatotoxic effects. 

Liver disease is the most common medical complication of alcohol abuse an estimated 15-30% of chronic heavy drinkers eventually develop severe liver disease. Alcoholic fatty liver, a reversible condition, may progress to alcoholic hepatitis and finally to cirrhosis and liver failure. In the United States, chronic alcohol abuse is the leading cause of liver cirrhosis and of the need for liver transplantation. The risk of developing liver disease is related both to the average amount of daily consumption and to the duration of alcohol abuse. Women appear to be more susceptible to alcohol hepatotoxicity than men. Concurrent infection with hepatitis or C virus increases the risk of severe liver disease. 

Two individuals with serum triglyceride concentrations over 11.3 mmol/1 (1000 mg/dl) were referred to a pharma-cist-managed lipid clinic by their primary-care provider because of either treatment failure or intolerance of conventional therapies (14). Fish oils were used in one case in lieu of and in the other in addition to conventional treatments. Although fish oil has not been reported to cause hepatotoxicity, both of these patients had increased transaminases while taking fish oil. Whether fish oil truly causes hepatic injury remains to be elucidated. 

Acetaminophen (paracetamol, 4-hydroxyacetanilide, APAP), a commonly used analgesic drug, causes centrilobular hepatic necrosis upon overdosage. APAP displays toxicity characteristics that demonstrate, very clearly, dependence upon GSH for protection. Hepatotoxicity, including liver failure, often occurs when APAP is... 

Kava extracts can, if overdosed (>60-120 mg kavapyr-ones/day) and/or taken over a longer period (>3 months), cause hepatotoxicity in the form of hepatic reactions and liver cell necrosis in rare cases, they may even cause cholestasis and acute liver failure (possibly leading to liver transplantation). Risk factors include the concomitant intake of medicaments and alcohol as well as a genetically based deficiency of cytochrome P450 2D6. (99, 116)... 

Liver injury that results in fulminant hepatic necrosis and acute hver failure is relatively rare. Wheu it occurs, death results iu days or weeks in nearly 80% of cases. Any potential hepatotoxic agent (e.g., acetaminophen) can be responsible, although viral hepatitis is the most common cause worldwide, especially HB V (1 % of patieuts with acute hepatitis B develop fuhniuaut hepatitis). " Fulmiuaut hepatitis caused by HAV occasiouaUy occurs acute liver failme caused by HCV is rare. ... 

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