DRUG-INDUCED LIVER INJURY: CURRENT STATE OF THE PROBLEM

DOI: https://doi.org/10.29296/25877305-2020-01-15
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Issue: 
1
Year: 
2020

V. Kutsenko(1), Candidate of Medical Sciences; E. Peresada(2); P. Seliverstov(3), Candidate of Medical Sciences (1)Saint Petersburg State Pediatric Medical University (2)S.M. Kirov Military Medical Academy, Saint Petersburg (3)North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg

Currently, drug-induced liver injury is a significant health problem. These damages are the result of clinical and morphological changes in the liver caused by direct or indirect adverse reaction to drugs and / or their metabolites. In the Russian Federation alone, about 5 thousands international generic names of medications are registered, and a quarter of them is potentially hepatotoxic. Moreover, the number of drugs is increasing annually and most of them are OTC - available without doctor’s prescription. The other, no less important problem is polypharmacy, unreasonable application of multiple medications simultaneously. Thus, current standards of care for a number of diseases require a simultaneous administration of 3-4 groups of medications, and in a polymorbid patient this figure can increase several times. It is important to note that drug administration occurs without a preliminary assessment of liver function, that increases the risk of drug related complications. The clinical manifestations of drug-induced liver injury are nonspecific and expressed to varying degrees. Currently, common standards of care for drug-induced liver injury have not been developed, and in some cases there are no specific antidotes. Therefore, the treatment of drug-induced liver injury, like any other toxic process begins with the discontinuation of the «guilty» drug that caused this disease, as well as the administration of hepatoprotective therapy. In our study, ursodeoxycholic acid is considered as the background therapy of drug-induced liver injury. A special attention is paid to preventive measures as well.

Keywords: 
hepatology
toxic hepatitis
drug-induced hepatitis
drug-induced liver damage
pharmacotherapy safety
ursodeoxycholic acid



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