Biomarkers of drug-induced liver toxicity

Therapeutic Drug Monitoring
Manuela G Neuman

Abstract

Drug-induced liver injury (DILI) is a comprehensive phenomenon. The injury to the liver may occur as an unexpected and undesired reaction to a therapeutic dose of a drug (idiosyncratic reaction), or as an expected therapeutic effect of the direct (intrinsic) toxicity of a drug taken in a large enough dose to cause liver injury.The direct toxicity (Type A) reactions represent an extension of the drug's therapeutic effect; they occur relatively frequently and are typically dose-related and frequency-of-exposure-related. In contrast, idiosyncratic reactions, or Type B reactions, are unpredictable, occurring only in susceptible individuals, and are unrelated to the dose or frequency of exposure. DILI encompasses both acute and/or chronic hepatic lesions. The liver injury may be the only clinical manifestation of the adverse drug effect. Otherwise it may be accompanied by injury to other organs, or by systemic manifestations. The liver injury may be observed in 1-8 days from taking the drug.DILI cases may result in the disapproval of a new drug or in the removal of a useful drug from the market by regulatory agencies. The purpose of this review is to provide guidance to facilitate the detection and assessment of hepatotoxicity induc...Continue Reading

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Citations

Oct 31, 2019·Yeungnam University Journal of Medicine·Jeong Ill Suh

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