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On hepatotoxicity of drugs used in dermatology

DOI: https://doi.org/10.29296/25877305-2020-09-09

E. Denisova(1, 4), Candidate of Medical Sciences; M. Denieva(2, 3), Candidate of Medical
Sciences; E. Dvoryankova(1), MD; K. Plieva(4); V. Sobolev(1), Candidate of Biological Sciences; Professor I.
Korsunskaya(1), MD (1)Center for Theoretical Problems of Physicochemical Pharmacology, Russian Academy of
Sciences, Moscow (2)Chechen State University, Groznyi (3)Republican Dermatovenereology Dispensary, Groznyi
(4)Moscow Research and Practical Center for Dermatovenereology and Cosmetology, Moscow Healthcare
Department, Moscow

Cutaneous reactions to various drugs are quite common, whereas hepatic reactions occur less frequently and may go unnoticed. Many drugs can damage the liver injuries; antiepileptic drugs, allopurinol, sulfonamides, antibiotics, and nevirapine are among the top 5 most common causes of drug-induced liver injuries. But let us not forget that the list of such drugs is much longer and it includes drugs that are widely used in different fields of medicine. Thus, systemic retinoids used long-term cause changes in blood biochemical parameters; these changes are often transient and do not require treatment discontinuation. Cyclosporine used to treat autoimmune diseases can cause increased creatinine levels and acute cholecystitis. Long-term use of methotrexate, even at low doses, or administration of systemic glucocorticosteroids can induce steatosis and other liver injuries. When prescribing medications that can cause disturbances in the hepatobiliary system, it is necessary to take into account a patient’s medical history and concomitant diseases, to regularly monitor blood biochemical parameters, and to incorporate hepatoprotective agents in therapy. The physician should also take into consideration possible drug interactions with the medications that the patient is already taking; this is particularly important in terms of the widespread use of polypharmacy. In our practice, we often give preference to a medication containing glycyrrhizic acid and essential phospholipids, since this combination has not only a hepatoprotective effect, but also has an anti-inflammatory effect. The inclusion of hepatoprotective agents in therapy on the first days allows avoidance of unwanted hepatotoxic effects that may be asymptomatic or irreversible in some cases.

glycyrrhizic acid
essential phospholipids
liver injuries

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