Of serum transaminase

A serious and potentially fatal adverse reaction to tolcapone ishepatic injury. Regular blood testing to monitor liver function is usually prescribed. The phys dan may order testing of serum transaminase levels at frequent intervals(eg, every 2 weeks for the first year and every 8 weeks thereafter). Treatment is discontinued if the ALT (SOFT) exceeds the upper normal limit or sgns or symptoms of liver failure develop. 

Elevations of serum transaminase concentrations generally are not correlated with the residual capacity of the liver to metabolize drugs, so these markers cannot be used directly as guides for residual metabolic capacity. Hepatically cleared TB drugs include isoniazid, rifampin, pyrazinamide, ethionamide, and p-aminosalicylic acid.39 Ciprofloxacin is about 50% cleared by... 

F8. Foulk, W. T., and Fleisher, G. A., The effect of opiates on the activity of serum transaminase. Proc. Staff Meet. Mayo Clin. 22, 405-410 (1957). 

Elevated serum transaminase /eve/s- Treatment-emergent elevations of serum transaminases (AST and /or ALT) above the upper limit of normal... 

Renal function Adequately hydrate all patients undergoing treatment. Exercise caution in using succimer therapy in patients with compromised renal function. Limited data suggest that succimer is dialyzable but that the lead chelates are not. Hepatic function Trans ent mild elevations of serum transaminases have been observed in 6% to 10% of patients during the course of therapy. Monitor serum transaminases before the start of therapy and at least weekly during therapy. 

Hepatotoxicity- Duloxetine increases the risk of elevation of serum transaminase levels. The combination of transaminase elevations and elevated bilirubin, without evidence of obstruction, is generally recognized as an important predictor of severe liver injury. Because it is possible that duloxetine and alcohol may interact to cause liver injury, duloxetine should ordinarily not be prescribed to patients with substantial alcohol use. 

Monitoring Make determinations of serum transaminase (AST, ALT) prior to and monthly during therapy. Monitor blood glucose and thyroid function tests periodically. Drug Interactions... 

Stevens W, Nabors CJ, Jr, Berliner DL. 1967. A comparison of serum transaminase levels and other serum constituents in dogs burdened with 239-Pu, 228-Th, 228-RA and 226-Ra. NY Acad Sci 145 817- 829. 

Side-effects of monobactams include occasional skin rashes and elevation of serum transaminases but major toxicity has not been reported. Penicillin-allergic patients can apparently tolerate these drugs. 

Patients should be warned that rifampicin colors urine, tears and other body fluids reddish-orange. Adverse effects further include rashes and pruritus and gastrointestinal complaints like nausea, anorexia and diarrhoea. With intermittent therapy a probably allergic hypersensitivity reaction can occur which mostly manifests itself as a flu-like syndrome with fever but can also result in nephritis and acute tubular necrosis. Elevation of serum transaminase levels occur frequently but clinical hepatitis is rare. Fatal outcome has been reported however. 

Contraindications Active hepatic disease unexplained, persistent elevations of serum transaminase levels... 

In the study of N. A. Gorchakova et al, Enterosgel was used for the treatment of fulminant hepatitis in rats caused by administration of tetrachloromethane [25], It was noted that enterosorption hampered hpid peroxidation in hver tissue of experimental animals, elevated activity of enzymes of the antioxidant pool and decreased activity of serum transaminases, which indicates better preservation of hepatocyte membranes. O.R. Grek et al, used multiple administrations of CCl in combination with drinking of 5% ethanol for modeling of chronic hepatitis in rats. They demonstrated a stable positive effect of Enterosgel administration on activity of serum transaminases and alkaline phosphatase, as well as the rate of hepatic metabolism of xenobiotics [26]. 

Mydriasis may occur and may precipitate an attack of acute glaucoma in some patients. Other reported but rare adverse effects include various blood dyscrasias a positive Coombs test with evidence of hemolysis hot flushes aggravation or precipitation of gout abnormalities of smell or taste brownish discoloration of saliva, urine, or vaginal secretions priapism and mild—usually transient—elevations of blood urea nitrogen and of serum transaminases, alkaline phosphatase, and bilirubin. 

Curcumin (9) is an arylheptanoid isolated from turmeric, the rhizome of Curcuma longa L. Turmeric has been used as a remedy for inflammatory in Asia for centuries. There are a number of reports supporting an anti-inflammatory effect of curcumin. Its hepatoprotective activity against inflammatory liver injury was also demonstrated in a recent study [105], where pretreatment with curcumin (50 mg/kg, p.o.) significantly inhibited the elevation of serum transaminase activities after intoxication with D-GalN and LPS in mice. The hepatoprotective effect is presumably... 

Borgaonkar MR, Marshall JK. Marked elevation of serum transaminases may be associated with ovarian hyperstimulation syndrome. Am J Gastroenterol 1999 94(11) 3373. 

The term transaminitis has been coined to describe a rise in the activities of serum transaminases without clinical symptoms. One author has suggested that in such cases one should switch from one statin to another, thereby preventing unnecessary withdrawal of statin treatment in dyslipidemic patients at high cardiovascular risk (25). 

Adverse effects Myelosuppression is the dose-limiting toxicity of gemcitabine. Other toxicities are nausea, vomiting, alopecia, and rash. Transient elevations of serum transaminases, proteinuria, and hematuria are common. Resistance to the drug is probably due to its inability to be converted to a nucleotide the tumor cell produces increased levels of endogenous deoxycytidine that compete for the kinase, thereby by-passing the inhibition. 

All the statins are reported to cause elevations in transaminases (ALT and AST), either transient or persistent. Rarely, hepatitis may develop. The SPCs of all statins contain a contraindication for their use in the presence of active liver disease or in patients with unexplained, persistent elevations of serum transaminases and any serum transaminase elevation exceeding three times ULN [1]. This may be extremely difficult to interpret in the light of a patient s clinical picture and their need for treatment. 

Ascorbic acid interferes with the autoanalyser determination of serum transaminases and lactic dehydrogenase (7,9). Serum bilirubin concentrations may be reduced by ascorbic acid, so that the presence of liver disease may be masked (9). 

Hepatotoxicity with cibenzoline has been rarely reported. There has been a report of slight rises in the activities of serum transaminases (16), and one of ischemic hepatitis (26). 

Hepatic veno-occlusive disease was attributed to low-dose cyclophosphamide in a 2-year-old child, and in repeated episodes of serum transaminase fluctuations in a patient with hepatitis C virus infection (SEDA-19, 347). 

During systemic administration, rises in the activities of serum transaminases and lactate dehydrogenase, skin reactions, eosinophilia, and altered vision have been noted (3). 

Exacerbation of chronic viral hepatitis In the treatment of chronic hepatitis B, HBe seroconversion was sometimes preceded by transient and moderate worsening of serum transaminases, but severe exacerbation of chronic hepatitis B infection and fatal liver failure can occur. Such fatalities were reported in under 0.5% of patients with hepatitis B (246). Patients with active cirrhosis or a previous history of decompensated cirrhosis are particularly susceptible to these complications (247). 

There were no differences in the activities of serum transaminases, lactate dehydrogenase, or creatine kinase in patients with myocardial infarction who received an 18-hour infusion of urokinase compared with patients who received glucose alone (38), but subacute alterations of liver function tests have been described with streptokinase and anistreplase (39). Unexplained increases in transaminase activities have been reported in almost 25% of patients treated with streptokinase (40). In view of the greater prominence of liver dysfunction with streptokinase than with alteplase it could be wiser to choose alteplase rather than streptokinase in patients with previous impaired hepatic function (41). 

Tocainide can increase the activities of serum transaminases (33) and can cause fatty change (33) and granulomatous hepatitis (34). 

Fortson W, Tedesco F, Starnes E, Shaw C. Marked elevation of serum transaminase activity associated with extrahepatic bhiary tract disease. J Clin Gastroenterol 1985 7 502-5. 

Isogai M, Hachisuka K, Yamaguchi A, Nakano S. Etiology and pathogenesis of marked elevation of serum transaminase in patients with acute gallstone disease. HPB Surg 1991 4 95-105 discussion 6-7. 

Effects on the liver are associated with exposure to hydrazines in humans (Sotaniemi et al. 1971) and animals (Haun and Kinkead 1973 Rinehart et al. 1960 Vemot et al. 1985 Wilson 1976). Therefore, assessment of serum transaminase activities may be useful in revealing liver damage in people exposed to hydrazines. Neurological effects are often observed following exposure to hydrazine and... 

Genasense) expression of Bcl-2, an antiapoptotic oncogene fatigue, elevation of serum transaminases, mild hyperglycemia, fever ... 

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