What medicines can lead to the development of disease?
As a rapidly developing drug-induced hepatitis?
Symptoms and signs of drug-induced hepatitis
Treatment of drug-induced hepatitis
Well known is the fact that almost every drug has side effects, harmful effects on the liver.
Since the liver acts as a natural filter entire organism when used in it a large number of drugs can accumulate toxins, thus causing toxic or drug-induced hepatitis.
Back to contents
Drug-induced hepatitis: causes
This inflammatory liver disease resulting from ingestion of certain drugs.
It is in 1-28% of cases, significantly complicates the ongoing pharmacotherapy and in 12-25% of cases leads to the development of liver failure and cirrhosis. Drug-induced hepatitis suffer 2-3 times more often women than men. In all, 10.2% of hospitalized patients develop drug-induced hepatitis of varying severity.
In elderly individuals increases susceptibility to hepatotoxic drugs. This is primarily due to a decrease in the intensity of hepatic blood flow and liver volume. The risk of hepatitis B drug increases with liver disease of various etiologies, as well as in the case of loss of kidney function.
A crucial role in the development of drug-induced hepatitis plays human sensitivity to a particular drug, it is determined by a number of factors:
genetic features of the human body (for example, if one of the parents suffered from hepatitis as a result of taking the drug, the likelihood that the same reaction would be, and the child is large enough);
liver condition while taking the medication (in patients with chronic hepatitis B is particularly strong toxic effects of drugs);
combination of drugs or of drugs and toxic substances. In the case of simultaneous use of 2 or more drugs toxic effects of drugs increases, or if the patient during treatment is exposed to toxins (poisonous gases, solvents, alcohol, etc.).
Back to contents
What medicines can lead to the development of disease?
Almost any drug can contribute to the development of drug-induced hepatitis. Its development depends on the individual, the particular properties of the drug, medication dosage, duration of his admission, as well as the number of drugs taken at the same time human.
Most of the risk of drug-induced liver observed in pregnant women, people who do not eat enough of protein foods (eg, vegetarians or people with limited cash option), long-term stress, as well as serious diseases of other organs (kidney failure, severe heart failure, etc.).
There are several groups of drugs that cause the disease more often than others.
These include:
anticonvulsants, antiepileptic drugs (phenytoin, clonazepam, carbamazepine, and others.);
anti-ulcer drugs (omeprazole);
antidiabetic drugs;
sulfonamides (Biseptolum, cotrimoxazole Sulfadimetoksin et al.);
diuretics (Hypothiazid, Furosemide and al.);
antiarrhythmic drugs (Amiodarone);
cytostatics (Cyclosporin A et al.).
Before the start of the use of any medication you should carefully read the instructions for its use and to be careful with respect to the onset of symptoms of the disease.
Back to contents
As a rapidly developing drug-induced hepatitis?
Currently, all drug-induced hepatitis is divided into 2 groups:
a direct toxic effect, it is a known, predictable and taken into account in the medicinal treatment of patients;
indirect effect is associated with increased sensitivity of patients, and is unpredictable.
By the nature of the disease is chronic and acute. Acute drug-induced hepatitis develops after taking the drugs about a week later and is quite rare. It usually occurs when you are hypersensitive to drugs and direct influence of drugs.
Chronic hepatitis drug typically develops gradually, and the clinical picture is similar to any existing liver disease. Time development of this form of the disease varies from a few months to several years. Risk of chronic hepatitis drug is that it can occur without symptoms, with no discoloration of the skin. If the patient stops taking the drug, even minor symptoms usually disappear.
Determine the exact time of occurrence of drug-induced hepatitis is impossible. In some cases, drug-induced liver develops after years of reception of a drug, in other cases, the disease can develop within a few hours or days after initiation of therapy.
The most complex form of drug liver disease - acute massive necrosis, ie death of liver tissue due to exposure to toxic substances. Acute massive liver necrosis develops quickly enough and soon leads to liver failure and cirrhosis.
The most serious disease, similar to drug-induced hepatitis, - Reye's syndrome, it occurs in children during acute viral infections took aspirin. As a rule, cancellation medication leads to recovery of the liver and cure the person.
Chronic drug-induced hepatitis occurs in patients who are forced for a long time to use some medication (anti, anti, anti-diabetic, anti-inflammatory drugs).
Back to contents
Symptoms and signs of drug-induced hepatitis
The disease has symptoms that are typical for almost any type of hepatitis:
vomiting, nausea, regurgitation with a bitter taste, loss of appetite, stool disorders (diarrhea, constipation), weight loss;
increase in the size of the spleen and liver;
jaundice - yellowing of the skin of the body, the mucous membrane of the mouth, or eyes;
a feeling of heaviness, pain, discomfort in the right upper quadrant;
darkening of the urine, lightening stool;
itching and subsequent scratching.
Since the symptoms of all types of hepatitis are similar, relying only on them, you can not specify the nature of hepatitis. If you have similar symptoms should see a doctor, who appointed the necessary research, will deliver an accurate diagnosis.
Diagnostics and research with medical hepatitis
urinalysis and blood;
biochemical blood analysis with determination of protein fractions and fractions of bilirubin, AST and ALT;
coagulation - the study of blood coagulation;
Ultrasonography of the abdomen.
If you suspect that the disease is necessary to make the biochemical analysis of blood, which determines the increase in transaminases (AST, ALT) - liver enzymes, indicating its defeat. Increased transaminase levels, as a rule, is the early sign of liver disease and precedes the onset of symptoms. Thus, patients who were forced to take a long time drugs, you should regularly check the level of transaminases in the blood to detect drug-induced hepatitis in the early stages.
To determine the real cause of hepatitis in case of characteristic symptoms can be difficult. However, the abolition of drug therapy, cause hepatitis, and further improvement of the patient clarify the situation. While improving the state of the drug administered again, and monitor the state of the liver. If the re-appointment medication condition worsens, it is safe to talk about drug-induced hepatitis.
Back to contents
Treatment of drug-induced hepatitis
The disease is quite dangerous that without proper treatment, can quickly go to cirrhosis of the liver and cause liver failure. Treatment of drug-induced hepatitis should take place under the supervision of the attending physician. Treatment consists of several steps:
the abolition of the drug that caused the drug liver damage. Cancel the drug that caused the disease, have to be agreed with the attending physician. It will assess the degree of risk the abolition of the drug and, if necessary, appoint another drug;
conduct detoxification therapy - removal from the blood of toxic substances that damage the liver. Usually, detoxification therapy includes a dropper with drugs cleans the blood (for example, gemodez);
then you need to carry out reparative therapy. This is done via hepatic that enhance metabolism in liver cells. These include drugs such as Essentiale forte, Geptral, methionine, etc .;
symptomatic therapy (if indicated).
When you receive drugs with severe hepatotoxic hepatoprotectors appointed the first days of therapy, drug toxicity and the end use of the drug. This principle of treatment helps prevent disease and provides an opportunity to carry out the necessary treatment (eg, tuberculosis).
In this disease, treatment should be carried out in compliance with a strict diet. If drug-induced hepatitis is recommended diet "table number 5", which is assigned to all the sick liver. It contains:
limiting receiving acute, fried and fatty foods;
split meals;
complete elimination of alcohol from the diet;
Eating foods high in carbohydrates;
extra cellular nutrition (vitamins, amino acids, minerals).
If drug-induced hepatitis prevention is very important to monitor the state of the liver during the therapy. To do this on a weekly basis are monitored levels of liver enzymes. After discharge control of the enzymes necessary to produce each month.
