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Clinics in Liver Disease

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https://www.readbyqxmd.com/read/27842778/drug-induced-hepatotoxicity%C3%A2-a-topic-where-we-don-t-know-enough
#1
EDITORIAL
Vinod K Rustgi
No abstract text is available yet for this article.
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842777/phenotypes-and-pathology-of-drug-induced-liver-disease
#2
REVIEW
Zachary D Goodman
Drug hepatotoxicity can simulate nearly any clinical syndrome or pathologic lesion that may occur in the liver, so clinical and histopathologic diagnosis of drug-induced liver injury may be difficult. Nevertheless, most drugs that are known to idiosyncratic liver injury tend to cause patterns of injury that produce characteristic phenotypes. Recognition of these patterns or phenotypes in liver biopsy material is helpful in evaluation of clinical cases of suspected drug-induced liver injury.
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842776/adverse-drug-reactions-type-a-intrinsic-or-type-b-idiosyncratic
#3
REVIEW
Carlo J Iasella, Heather J Johnson, Michael A Dunn
Hepatotoxic adverse drug reactions are associated with significant morbidity and mortality and are the leading cause of postmarketing regulatory action in the United States. They are classified as Type A (intrinsic) or Type B (idiosyncratic). Type A are predictable, dose-related toxicities, often identified in preclinical or clinical trials, and usually occur in overdose settings or with pre-existing hepatic impairment. Type B are not clearly related to increasing dose and are associated with drug-specific and patient-specific characteristics and environmental risks...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842775/epidemiology-and-genetic-risk-factors-of-drug-hepatotoxicity
#4
REVIEW
Jawad Ahmad, Joseph A Odin
Idiosyncratic drug-induced liver injury (DILI) from prescription medications and herbal and dietary supplements has an annual incidence rate of approximately 20 cases per 100,000 per year. However, the risk of DILI varies greatly according to the drug. In the United States and Europe, antimicrobials are the commonest implicated agents, with amoxicillin/clavulanate the most common, whereas in Asian countries, herbal and dietary supplements predominate. Genetic analysis of DILI is currently limited, but multiple polymorphisms of human leukocyte antigen genes and genes involved in drug metabolism and transport have been identified as risk factors for DILI...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842774/mechanisms-of-drug-induced-hepatotoxicity
#5
REVIEW
Amina Ibrahim Shehu, Xiaochao Ma, Raman Venkataramanan
Drug-induced hepatotoxicity (DIH) is a significant cause of acute liver failure and liver transplantation. Diagnosis is challenging due to the idiosyncratic nature, its presentation in the form of other liver disease, and the lack of a definite diagnostic criteria. Generation of reactive metabolites, oxidative stress, and mitochondrial dysfunction are common mechanisms involved in DIH. Certain risk factors associated with a drug and within an individual further predispose patients to DIH.
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842773/drug-induced-liver-disease-clinical-course
#6
REVIEW
Hemamala Saithanyamurthi, Alison Jazwinski Faust
Drug-induced liver injury (DILI) is a term used to describe a spectrum of clinical presentations and severity that ranges from mild elevation of liver enzymes on routine blood work to acute liver failure and death. Approximately 10% of all patients with DILI develop acute liver failure resulting in death or liver transplantation. DILI may be prolonged with persistence of elevated liver enzymes for longer than 6 months in approximately 5% to 20% of cases. Cirrhosis and long-term liver-related morbidity and mortality have also been described but are rare, occurring in 1% to 3% of cases...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842772/evolution-of-experimental-models-of-the-liver-to-predict-human-drug-hepatotoxicity-and-efficacy
#7
REVIEW
Lawrence A Vernetti, Andreas Vogt, Albert Gough, D Lansing Taylor
In this article, we review the past applications of in vitro models in identifying human hepatotoxins and then focus on the use of multiscale experimental models in drug development, including the use of zebrafish and human cell-based, 3-dimensional, microfluidic systems of liver functions as key components in applying Quantitative Systems Pharmacology (QSP). We have implemented QSP as a platform to improve the rate of success in the process of drug discovery and development of therapeutics.
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842771/drug-metabolism-drug-interactions-and-drug-induced-liver-injury-in-living-donor-liver-transplant-patients
#8
REVIEW
Swaytha Ganesh, Omar Abdulhameed Almazroo, Amit Tevar, Abhinav Humar, Raman Venkataramanan
Living donor liver transplant (LDLT) fills a critically needed gap in the number of livers available for transplant. However, little is known about the functional recovery of the liver in the donor and in the recipient after surgery. Given that both donor and recipients are treated with several drugs, it is important to characterize the time course of recovery of hepatic synthetic, metabolic, and excretory function in these patients. In the absence of data from LDLT, information on the effect of liver disease on the pharmacokinetics of medications can be used as guidance for drug dosing in LDLT patients...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842770/management-of-acute-hepatotoxicity-including-medical-agents-and-liver-support-systems
#9
REVIEW
Humberto C Gonzalez, Syed-Mohammed Jafri, Stuart C Gordon
Drug-induced liver injury (DILI) can be predictable or idiosyncratic and has an estimated incidence of approximately 20 cases per 100,000 persons per year. DILI is a common cause of acute liver failure in the United States. No accurate tests for diagnosing DILI exist, and its diagnosis is based on exclusion of other conditions. Managing DILI includes discontinuing the suspected causative agent and in selected cases administering an antidote. Liver support systems are used for long-term support or as a bridge to transplantation and are effective for improving encephalopathy, hyperbilirubinemia, and other liver-related conditions, but whether they improve survival remains uncertain...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842769/drug-induced-acute-liver-failure
#10
REVIEW
Shahid Habib, Obaid S Shaikh
Drug-induced acute liver failure (ALF) disproportionately affects women and nonwhites. It is most frequently caused by antimicrobials and to a lesser extent by complementary and alternative medications, antiepileptics, antimetabolites, nonsteroidals, and statins. Most drug-induced liver injury ALF patients have hepatocellular injury pattern. Cerebral edema and intracranial hypertension are the most serious complications of ALF. Other complications include coagulopathy, sepsis, metabolic derangements, and renal, circulatory, and respiratory dysfunction...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842768/herbal-and-dietary-supplement-induced-liver-injury
#11
REVIEW
Ynto S de Boer, Averell H Sherker
The increase in the use of herbal and dietary supplements (HDSs) over the last decades has been accompanied by an increase in the reports of HDS-associated hepatotoxicity. The spectrum of HDS-induced liver injury is diverse and the outcome may vary from transient liver test increases to fulminant hepatic failure resulting in death or requiring liver transplant. There are no validated standardized tools to establish the diagnosis, but some HDS products have a typical clinical signature that may help to identify HDS-induced liver injury...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842767/drug-hepatotoxicity-newer-agents
#12
REVIEW
Chalermrat Bunchorntavakul, K Rajender Reddy
Idiosyncratic hepatotoxicity is one of the most common reasons for an approved drug being restricted. This article focuses on hepatotoxicity of selected and recently introduced agents, such as, tyrosine kinase inhibitors, monoclonal antibodies, novel oral anticoagulants, newer antiplatelets, antibiotics, anti-diabetics, anti-epileptics, anti-depressants, anti-psychotics and anti-retrovirals. Overall, the incidence of clinically relevant hepatotoxicity from newer agents seems to be lower than that of the older agents...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842766/drug-hepatotoxicity-environmental-factors
#13
REVIEW
Jonathan G Stine, Naga P Chalasani
Drug-induced liver injury presents as various forms of acute and chronic liver disease. There is wide geographic variation in the most commonly implicated agents. Smoking can induce cytochrome P450 enzymes but this does not necessarily translate into clinically relevant drug-induced liver injury. Excessive alcohol consumption is a clear risk factor for intrinsic hepatotoxicity from acetaminophen and may predispose to injury from antituberculosis medications. Understanding of the role of infection, proinflammatory states, disorders of coagulation, and the hepatic clock in predisposing patients to drug-induced liver injury is evolving...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27842765/drug-metabolism-in-the-liver
#14
REVIEW
Omar Abdulhameed Almazroo, Mohammad Kowser Miah, Raman Venkataramanan
Metabolism is a biotransformation process, where endogenous and exogenous compounds are converted to more polar products to facilitate their elimination from the body. The process of metabolism is divided into 3 phases. Phase I metabolism involves functionalization reactions. Phase II drug metabolism is a conjugation reaction. Phase III refers to transporter-mediated elimination of drug and/or metabolites from body normally via liver, gut, kidney, or lung. This review presents basic information on drug-metabolizing enzymes and potential factors that might affect the metabolic capacities of the enzyme or alter drug response or drug-mediated toxicities...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27742012/hepatitis-b-virus-the-past-the-present-and-the-future
#15
Tarek I Hassanein
No abstract text is available yet for this article.
November 2016: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27742011/toward-elimination-of-hepatitis-b-virus-using-novel-drugs-approaches-and-combined-modalities
#16
REVIEW
Sebastien Boucle, Leda Bassit, Maryam Ehteshami, Raymond F Schinazi
Hepatitis B virus (HBV) causes significant morbidity and mortality worldwide. The majority of chronically infected individuals do not achieve a functional and complete cure. Treated persons who achieve a long-term sustained virologic response (undetectable HBV DNA), are still at high risk of developing morbidity and mortality from liver complications. This review focuses on novel, mechanistically diverse anti-HBV therapeutic strategies currently in development or in clinical evaluation, and highlights new combination strategies that may contribute to full elimination of HBV DNA and covalently closed circular DNA from the infected liver, leading to a complete cure of chronic hepatitis B...
November 2016: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27742010/the-management-of-hepatitis-b-in-liver-transplant-recipients
#17
Sammy Saab, Ping-Yu Chen, Clara E Saab, Myron J Tong
Liver transplant (LT) is now an established indication for patients with chronic hepatitis B, mainly because of the development and use of hepatitis B immunoglobulin (HBIG) and oral antivirals for prophylaxis. The combination of low-dose HBIG and antivirals has been considered the standard prophylaxis regimen to prevent post-LT recurrence of hepatitis B. The important remaining issues are related to the long-term cost of HBIG and the risk of escape hepatitis B virus (HBV) mutants. Strategies for prevention of HBV after LT are constantly improving...
November 2016: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27742009/hepatitis-b-and-hepatocellular-carcinoma
#18
Alan W Hemming, Jennifer Berumen, Kristin Mekeel
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death worldwide, and its incidence has been increasing in the last decade largely in parallel to the incidence and duration of exposure to hepatitis B and C. The widespread implementation of hepatitis B vaccine, hepatitis B antivirals, and the introduction of direct antiviral therapies for hepatitis C virus may have a substantial impact in reducing the incidence of HCC. This report reviews the risk factors and underlying mechanisms associated with the development of HCC in hepatitis B, along with advances in the diagnosis, imaging, and management of HCC...
November 2016: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27742008/hepatitis-b-and-risk-of-non-hepatocellular-carcinoma-malignancy
#19
Ryan M Kwok, Tram T Tran
Chronic hepatitis B infection (CHB) is a known risk factor for malignancy. Unlike hepatocellular carcinoma (HCC), less is known about the risk of non-HCC malignancy. However, epidemiology and pathologic evidence suggests a strong association between non-Hodgkin lymphoma and CHB. Data regarding the risk of other malignancies, such as pancreatic adenocarcinoma and intrahepatic cholangiocarcinoma, are mixed. Surveillance and appropriate treatment of infection and malignancy in these patients is essential. Further study of these associations is needed and may bring new insights in the pathogenesis and treatment of these diseases...
November 2016: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27742007/hepatitis-b-virus-infection-and-liver-decompensation
#20
Brendon K Luvisa, Tarek I Hassanein
The goal in patients with immune active hepatitis B virus (HBV) infection is to significantly suppress viral replication and prevent progression of fibrosis to cirrhosis and liver decompensation and decrease the incidence of hepatocellular carcinoma. This is achievable by the highly active antivirals, entecavir and tenofovir, which are considered first-line therapy in most patients with immune active hepatitis C virus and after liver transplantation to prevent HBV recurrence. Patients with decompensated cirrhosis should be referred for liver transplantation and treated with first-line antivirals as early as possible, with the goal of achieving complete viral suppression in the shortest time possible...
November 2016: Clinics in Liver Disease
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