Treatment of Hepatotoxicity

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Year : 2025 | Volume :15 | Issue : 01 | Page : –
By
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Priyanka .,

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Priyanka Rai,

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Samriti Bhardwaj,

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Yashika,

  1. Research Scholar, Department of Pharmacology, School of Pharmaceutical Sciences CT University, Ludhiana, Punjab, India
  2. Assistant Professor, Department of Pharmaceutics, CT Institute of Pharmaceutical Sciences, Shahpur, Jalandhar,, Punjab, India
  3. Assistant Professor, Department of Pharmaceutics, CT Institute of Pharmaceutical Sciences, Shahpur, Jalandhar,, Punjab, India
  4. Research Scholar, Department of Pharmacology, CT Institute of Pharmaceutical Sciences, Shahpur, Jalandhar, Punjab, India

Abstract

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An instantaneous or prolonged response to a synthetic or natural substance is known as drug-induced liver injury, or drug-induced hepatotoxicity (DILI). There are two distinct pathways that lead to hepatotoxicity: the more unpredictable idiosyncratic mechanism and the dose-dependent intrinsic mechanism. Several pathways, some known and others speculated, may be involved in the emergence of drug-induced damage. Drug-induced liver impairment can have a number of causes, and elevated liver tests are one of them. Excluding all alcoholic, non-alcoholic fatty liver, autoimmune, and hepatitis-like viral causes of liver illness is crucial. The best line of treatment is to cease taking any drugs that put undue strain on the liver and replace them with ones that mitigate or control the side effects of hepatotoxicity. Stopping up alcohol may also reduce your chance of developing hepatotoxicity. It has been demonstrated that intravenous carnitine and rapid N-acetylcysteine administration following an acetaminophen overdose can be used to treat liver disease and acute valproate-induced hepatotoxicity, respectively. A herbal hepatoprotective medication silymarin, a lavonolignan produced from Silybum marianum, often known as milk thistle, functions by blocking lipid peroxidation, reducing inflammation, stabilizing membranes, enhancing the immune system, and encouraging liver regeneration.

Keywords: Hepatotoxicity, drug induced liver injury(DILI), cyP450

[This article belongs to Omni Science: A Multi-disciplinary Journal (osmj)]

How to cite this article:
Priyanka ., Priyanka Rai, Samriti Bhardwaj, Yashika. Treatment of Hepatotoxicity. Omni Science: A Multi-disciplinary Journal. 2025; 15(01):-.
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Priyanka ., Priyanka Rai, Samriti Bhardwaj, Yashika. Treatment of Hepatotoxicity. Omni Science: A Multi-disciplinary Journal. 2025; 15(01):-. Available from: https://journals.stmjournals.com/osmj/article=2025/view=0

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References

  1. Fisher K, Vuppalanchi R, Saxena R. Drug-Induced Liver Injury. Arch Pathol Lab Med. 2015 Jul;139(7):876-87.
  2. Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, Watkins PB, Navarro V, Barnhart H, Gu J, Serrano J., United States Drug Induced Liver Injury Network. Features and Outcomes of 899 Patients With Drug-Induced Liver Injury: The DILIN Prospective Study. Gastroenterology. 2015 Jun;148(7):1340-52.e7.
  3. Katarey D, Verma S. Drug-induced liver injury. Clin Med (Lond). 2016 Dec;16(Suppl 6):s104-s109.
  4. Kuna L, Bozic I, Kizivat T, Bojanic K, Mrso M, Kralj E, Smolic R, Wu GY, Smolic M. Models of Drug Induced Liver Injury (DILI) – Current Issues and Future Perspectives. Curr Drug Metab. 2018;19(10):830-838.
  5. Chalasani NP, Hayashi PH, Bonkovsky HL, Navarro VJ, Lee WM, Fontana RJ., Practice Parameters Committee of the American College of Gastroenterology. ACG Clinical Guideline: the diagnosis and management of idiosyncratic drug-induced liver injury. Am J Gastroenterol. 2014 Jul;109(7):950-66; quiz 967.
  6. Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH. Liver injury from herbal and dietary supplements. Hepatology. 2017 Jan;65(1):363-373.
  7. Tujios SR, Lee WM. Acute liver failure induced by idiosyncratic reaction to drugs: Challenges in diagnosis and therapy. Liver Int. 2018 Jan;38(1):6-14.
  8. European Medicines Agency. [(accessed on 1 May 2015)].
  9. Physician Desk Reference (PDR) [(accessed on 1 May 2015)].
  10. Bjornsson E.S., Jacobsen E.I., Einarsdottir R., Chalasani N. Discrepancies in liver disease labeling in the package inserts of commonly prescribed medications. Gastroenterology. 2015;148:269–273. doi: 10.1053/j.gastro.2014.12.007.
  11. Andrade R.J., Robles M., Lucena M.I. Rechallenge in drug-induced liver injury: The attractive hazard. Expert Opin. Drug Saf. 2009;8:709–714. doi: 10.1517/14740330903397378.
  12. Papay J.I., Clines D., Rafi R., Yuen N., Britt S.D., Walsh J.S., Hunt C.M. Drug-induced liver injury following positive drug rechallenge. Regul. Toxicol. Pharmacol. 2009;54:84–90. doi: 10.1016/j.yrtph.2009.03.003
  13. Zimmerman H.J. Drug-induced liver disease. In: Sciff E.R., Sorrell M.F., Maddrey W.C., editors. Diseases of the Liver. 8th ed. Schiff’s Lippincott-Raven Publishers; Philadelphia, PA, USA: 1999. pp. 973–1064.
  14. Agarwal V.K., McHutchison J.G., Hoofnagle J.H. Important elements for the diagnosis of drug-induced liver injury. Clin. Gastroenterol. Hepatol. 2010;8:463–470. doi: 10.1016/j.cgh.2010.02.008.
  15. Saukkonen JJ, Cohn DL, Jasmer RM, Schenker S, Jereb JA, et al. (2006) An Oficial ATS Statement: Hepatotoxicity of antituberculosis therapy. Am J Respir Crit Care Med 174: 935-952.
  16. Naruse K, Tang W, Makuuchi M (2007) Artiicial and bioartiicial liver support: A review of perfusion treatment for hepatic failure patients. World J Gastroenterol 13: 1516-1521.
  17. Zimmerman HJ. Hepatotoxicity: The Adverse Effects of Drugs and Other Chemicals on the Liver. Philadelphia: Lippincott Williams & Wilkins, 1999
  18. Watkins PB. Mechanisms of drug-induced liver disease. In: Schiff ER, Sorrell M, Maddrey WC, eds. Schiff’s Diseases of the Liver, 9 ed. Philadelphia: Lippincott Williams & Wilkins, 2003:1129–1145.
  19. Pessayre D, Fromenty B, Mansouri A, et al. Hepatotoxicity due to mitochondrial injury. In: Kaplowitz N, DeLeve LD, eds. Drug-Induced Liver Disease, 1st ed. New York: Marcel Dekker, 2003:55–83.
  20. Berson A, DeBeco V, Lette´ron P, et al. Steatohepatitis-inducing drugs cause mitochondrial dysfunction and lipid peroxidation in rat hepatocytes. Gastroenterology. 1998;114:764–774.
  21. Weinshilboum R. Inheritance and drug response. N Engl J Med. 2003; 348:529–537.
  22. Phillips KA, Veenstra DL, Oren E, et al. Potential role of pharmacogenomics in reducing adverse drug reactions. JAMA. 2001;286:2270–2279.
  23. Evans WE, McLeod HL. Pharmacogenomics: drug disposition, drug targets, and side effects. N Engl J Med. 2003;348:538–547.
  24. Beaune P, Dansette PM, Mansuy D, et al. Human anti-endoplasmic reticulum autoantibodies appearing in a drug-induced hepatitis are directed against a human liver cytochrome P-450 that hydroxylates the drug. Proc Natl Acad Sci USA. 1987;84:551–555.
  25. Lucena MI, Andrade RJ, Kaplowitz N, et al. Phenotypic characterization of idiosyncratic drug-induced liver injury: the influence of age and sex. Hepatology 2009;49(6):2001–9.
  26. Chalasani N, Bjo¨rnsson E. Risk factors for idiosyncratic drug-induced liver injury. Gastroenterology 2010;138(7):2246–59.
  27. Meng X, Maggs JL, Usui T, et al. Auto-oxidation of isoniazid leads to isonicotiniclysine adducts on human serum albumin. Chem Res Toxicol 2014;28(1):51–8.
  28. Larrey D, Vial T, Micaleff A, et al. Hepatitis associated with amoxycillin-clavulanic acid combination report of 15 cases. Gut 1992;33(3):368–71.
  29. Huang YS, Chern HD, Su WJ, et al. Cytochrome P450 2E1 genotype and the susceptibility to antituberculosis drug-induced hepatitis. Hepatology 2003; 37(4):924–30.
  30. Russmann S, Kullak-Ublick GA, Grattagliano I. Current concepts of mechanisms in drug-induced hepatotoxicity. Curr Med Chem 2009;16(23):3041–53
  31. Andrade RJ, Robles M, Ulzurrun E, et al. Drug-induced liver injury: insights from genetic studies. Pharmacogenomics 2009;10(9):1467–87.
  32. Daly AK, Donaldson PT, Bhatnagar P, et al. HLA-B* 5701 genotype is a major determinant of drug-induced liver injury due to flucloxacillin. Nat Genet 2009; 41(7):816–9.
  33. Lammert C, Bjornsson E, Niklasson A, et al. Oral medications with significant hepatic metabolism at higher risk for hepatic adverse events. Hepatology 2010;51(2):615–20. Mechanisms of Drug-Induced Hepatotoxicity 49
  34.  Lammert C, Einarsson S, Saha C, et al. Relationship between daily dose of oral medications and idiosyncratic drug-induced liver injury: search for signals. Hepatology 2008;47(6):2003–9.
  35. Chalasani N, Fontana RJ, Bonkovsky HL, et al. Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology 2008;135(6):1924–34, 1934.e1-4.
  36. Gayam V, Khalid M, Shrestha B, Hossain MR, Dahal S, Garlapati P, Gill A, Mandal AK, Sangha R. Drug-Induced Liver Injury: An Institutional Case Series and Review of Literature. J Investig Med High Impact Case Rep. 2018 Jan-Dec;6:2324709618761754
  37. Tajiri K, Shimizu Y. Practical guidelines for diagnosis and early management of drug-induced liver injury. World J Gastroenterol. 2008 Nov 28;14(44):6774-85.
  38. Polson J, Lee WM. (2005) AASLD position paper: the management of acute liver failure. Hepatology 41: 1179-1197.
  39. Bohan TP, Helton E, McDonald I, Konig S, Gazitt S, et al. (2001) Effect of L-carnitine treatment for valproate-induced hepatotoxicity. Neurology 41: 1405-1409.
  40. Bhragual DD, Kumar N, Garg VK, Sharma PK (2010) Review on plants having hepatoprotective activity. J Pharm Res 3: 2077-2082.
  41. Mohamed Saleem TS, Madhusudhana Chetty C, Ramkanth S, Rajan VST, Mahesh Kumar K, et al. (2010) Hepatoprotective Herbs – A Review. Int J Res Pharm Sci 1: 1-5.
  42. Vishnu Priya V, Niveda S, Pratiksha G, Gayathri R (2010) A review of hepatoprotective natural products. Recent Research in Science and Technology 2: 49-52.
  43. Deshwal N, Sharma AK, Sharma Piush (2011) Review on hepatoprotective plants. International Journal of Pharmaceutical Sciences Review and Research 7: 15-26.
  44. Pradhan SC and Girish C (2006) Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine. Indian J Med Res 124: 491- 504.
  45. Xu JJ, Diaz D, O’Brien PJ (2004) Applications of cytotoxicity assays and prelethal mechanistic assays for assessment of human hepatotoxicity potential. Chemico-Biol Interact 150: 115-128.
  46. CDER (2005) Report to the Nation: Improving Public health through Human Drugs. Food and Drug Administration, Centre for Drug Evaluation and Research, US Department of Health and Human Services.
  47. Goldkind L, Laine L (2006) A systematic review of NSAIDS withdrawn from the market due to hepatotoxicity: Lessons learned from the bromfenac experience. Pharmacoepidemiol Drug Saf 15: 213-220.
Regular Issue Subscription Review Article
Volume 15
Issue 01
Received 14/10/2024
Accepted 08/11/2024
Published 23/01/2025
75