Introduction
The liver assumes a significant part in the digestion and expulsion of medications. Detoxification of medications and xenobiotic in the liver by drug utilizing chemicals (DMEs) is a significant wonder in the securing of homeostasis.1 The liver is an imperative organ and its key area and multidimensional capacities uphold pretty much every other organ in the body. Liver is likewise the primary organ for digestion and disposal of medications.2 Poisonous hepatitis is the most extreme antagonistic response to antituberculosis drugs, it as a rule starts in the initial not many long stretches of treatment alongside liver rot, which may advance to encephalopathy and demise. Alcoholic liver illnesses with cirrhosis (development of stringy tissue in liver) brought about by unreasonable liquor utilization is a typical event. Liver can once in a while be harmed by certain synthetic substances called hepatotoxins. 3 Drug-induced liver injury (DILI) is the most continuous sign for drug withdrawal from the drug market because of its relationship with noteworthy antagonistic impacts, dismalness, and mortality. 4 DILI is liable for most of intense liver disappointment cases and is currently the main source for liver transplantation among patients. 5 It is critical to perceive that DILI is generally named characteristic (or direct) versus particular. Natural DILI is regularly portion related and happens in a huge extent of people presented to the medication (unsurprising) and beginning is inside a brief timeframe length (hours to days). 6
Table 1
Types of drug induced liver injury 7
Types of liver diseases and its symptom
There are various types of liver disease mentioned bellow in the table.8, 9, 10
Table 2
Types of liver diseases and its symptom
Table 3
Types of drug induced liver disease and its mechanism
|
Liver diseases |
Drugs |
Mechanism |
|
Zonal necrosis |
Paracetamol, carbon tetrachloride, Amatoxins |
Cessation of protein synthesis due to the inhibition of RNA synthesis, largely confined to a particular zone of the liver lobule 1 |
|
Cholestasis |
Chlorpromazine, estrogen, erythromycin and its derivatives 11 |
Impairment of bile flow, itching and jaundice. Injury to canalicular membrane and transporters (Kaplowitz; 2004). |
|
Steatosis |
Carbamazepine 12 |
Triglyceride accumulation which leads to either small droplet [micro vesicular] or large droplet [macro vesicular] fatty liver |
|
Micro vesicular fats Non-alcoholic steatohepatitis Lactic acidosis |
Didanosine, tetracycline, acetylsalicylic acid, valproic acid Amiodarone, tamoxifen Zidovudine, riboflavin, metformin |
Altered mitochondrial respiration, β- oxidation leads to lactic acidosis and triglyceride accumulation12 |
|
Granuloma |
Diltiazem, sulfa drugs, quinidine |
Granulomas located in periportal or portal areas and show features of systemic vasculitis and hypersensitivity, Macrophages, lymphocytes infiltrate hepatic lobule. |
|
Vascular lesions/collapse 13 |
Nicotinic acid, cocaine, methylenedioxymeth amphetamine |
Injury to the vascular endothelium/ Causes ischemic or hypoxic injury. |
|
Oncogenesis |
Oral contraceptives, androgens |
Encourages tumor formation 13 |
|
Veno- occlusive 14 |
Busulfan, cyclophosphamide |
Injury to the hepatic venous endothelium. |
Table 4
Conclusion
Drug induced Liver Injury harm goes from the unusual and non-portion identified with that happening typically after overdoses. It may include digestion to harmful, receptive intermediates, obstruction, with film transport or with cell natural chemistry, for example, protein amalgamation, or immunological instruments and contrasts in resistant responsiveness, hereditary, dietary and different variables. The liver is dependent upon expected harm from a gigantic exhibit of drug operators, Natural poisons, metals and metalloids, mycotoxins, endotoxins.