Often hepatocyte damage caused by drugs and toxins is posljedaica its central role in metabolism. Situated between gastroitestinalnog tract and peripheral organs, is exposed to permanently entered foreign substances whose metabolism can result in toxic compounds intermedia, which may cause or increase the liver damage already present. Many drugs and toxins that enter the body through the gastrointestinal tract require the conversion of insoluble to water soluble metabolites in order to be excreted via urine or bile.
Toxic liver damage is damage caused by the action of various chemical poisons and many drugs. Because the liver is the main organ in which degrade and detoxify drugs and chemical compounds, toxic damage are quite common and can mimic any form of liver disease.
Risk factors for toxic liver damage
Sensitivity to toxic liver damage is determined by numerous factors such as age, sex, genetic factors, pregnancy, nutritional status and the possible associated diseases. Thus, the increased sensitivity of older people in drug hepatotoxicity. Women are predisposed to the occurrence of chronic hepatitis in the use of drugs such as nitrofurantoin or diclofenac while holostatske drug reactions occur equally in both sexes. The thickness may increase the risk of hepatotoxicity due to prolonged drug exposure of hepatic drug soluble in fats that are deposited in adipose tissue.
Changes in the liver
Toxic or damage arising as a direct toxic action of harmful agents, or it comes to immune mediated damage. Since we distinguish two types of damage: predictably, caused by hepatotoxic compounds and nepridivo damage caused by idiosinkartičnim hepatotoksinima.
Toxic oštećenjeobuhvata various changes in the liver of fatty changes and cholestasis and necrosis of hepatocytes, including fatty necrosis of the liver failure, the image of similar acute and chronic viral hepatitis to cirrhosis, so it can mimic any liver disease. Drugs is caused by about 30% of all cases of fulminant hepatitis with massive hepatic necrosis.
The clinical picture of toxic hepatitis is usually nonspecific. Many drugs cause non-specific picture of viral hepatitis with nausea, anorexia and vomiting, and later the possible occurrence of abdominal pain and jaundice. Fever, rash and artragije, are typical signs of hypersensitivity reactions to drugs, but these symptoms may be present in viral hepatitis. Acute liver injury develops in three stages. First appearing heavy and severe gastrointestinal neuro symptoms, followed by a period of temporary poboljšanbja clearly and finally liver failure with multiple organ failure.
Kliničnih nonspecific manifestations of toxic hepatitis are diagnosed at an early stage is very difficult. Worsening of liver disease may indicate deterioration of liver disease early, before complications of liver disease or sepsis.Adding a large number of drugs are very ill further complicates diagnosis of toxic hepatitis. Safe clinical diagnosis of toxic hepatitis can be set up after taking a drug or toxin, followed by presentation of disease, and after termination of exposure, due to improvement. It is therefore important to read the instructions before taking lijjeka.
The diagnosis of toxic liver damage
Increase the value of ALT and AST at least two times above normal, and the ratio of ALT / AST greater than 5 are the most common features hepaticelularnog Feelings liver medication. Cholestatic injury is characterized by at least twofold increase in alkaline phosphatase (AP) and the ratio of ALT / AP less than 2 However, many drugs cause mixed type of injury. Hypoalbuminemia has been associated with toxicity salicata. Lymphocytosis and eosinophilia are associated with immune phenomena. Leukopenia and tombocitopenija can be related to disseminated intravascular coagulation when it occurs with severe toxic hepatitis. Prolonged prothrombin time hard warns of damaged liver function and is an important prognostic sign. It is useful toxicological findings in suspected high doses of drugs and toxins.
Ultrasound and computed tomography are useful in excluding other causes of liver disease, as well as in tumor diagnosis. Doppler analysis is important in the diagnosis of hepatic vascular diseases uzrokopvanim drugs. Liver biopsy is a useful diagnostic to identify the type of liver damage and its severity.
Treatment
The main therapeutic measure was discontinuation of hepatotoxic drugs. Most patients will recover, and will rarely cause further deterioration.
Useful information about health and healthy diet you can
find on:
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.