How is drug-induced hepatitis manifested? Types, symptoms, prevention
It is well known that almost every drug has side effects and has a harmful effect on the liver. Since the liver is a natural filter of our body, in it, when you consume a large number of drugs, poisons accumulate, causing toxic or drug-induced hepatitis.
Types and Classification of Drug-Based Hepatitis
Currently, there is a large number of drugs known to have toxic effects on liver tissue. And most of all, young children and elderly people are at risk of hepatic intoxication.
The liver has an enzymatic system, through which the conversion of drugs into harmless components, and harmful - are eliminated from the body. In the course of this process intermediates are formed - metabolites, which have a toxic effect.
Toxic hepatitis develops when the following forms are used:
- Cytotoxic drugs( Cyclosporine).
- Anti-tuberculosis drugs( Rifampicin, Isoniazid).
- Antibiotics and sulfonamide preparations( Tetracycline, Erythromycin, Biseptol).
- Hormonal preparations( corticosteroids, contraceptives, steroids).
- Non-steroidal anti-inflammatory drugs( Diclofenac, Aspirin).
- Diuretics( Hypothiazide, Furosemide).
- Antiepileptic and anticonvulsants( carbamazepine, phenytoin).
- Anti-ulcer drugs( omeprazole).
- Antiarrhythmics( Amiodarone).
Currently, all medicinal hepatitides are divided into two groups:
- Direct toxic effect, which is predictable, known and taken into account in the drug therapy of patients.
- Indirect exposure, which is unpredictable and associated with hypersensitivity of patients.
According to the nature of the disease, the disease can be acute and chronic. Acute appearance about a week after taking the tablets, and is very rare. Usually this happens with direct exposure to drugs and individual intolerance to drugs.
The chronic appearance develops gradually, and the clinical picture resembles all existing liver diseases. The time of development of this form of hepatitis can range from several months to several years.
Symptoms of the disease
When the disease is drug-induced, hepatitis symptoms are manifold, and are manifested in the following:
- Nausea, sometimes vomiting.
- Stool disorder.
- General malaise and weakness.
- Pain or heaviness in the right upper quadrant.
- Change in the color of the skin and mucous membranes.
- Skin itching with subsequent combing.
- Increase in liver and spleen size.
The danger of chronic drug hepatitis is that it can leak and asymptomatically, without changing the color of the skin. Usually even minor symptoms disappear if the patient stops taking medication.
Diagnose hepatitis, based on patient complaints, symptoms, general blood and urine tests, as well as biochemical and ultrasound data. For the subsequent successful treatment it is very important to find and mark those medicines that caused toxic hepatitis. If the patient has taken many medications, it is important to take them separately and note when the state of health worsens.
Effective treatment of
The main therapy and the main conditions for a successful result is the withdrawal of a drug that could cause drug-induced hepatitis. Earlier in the treatment, forced diuresis( vigorous urination) and treatment with drugs of metabolic action were used.
At present, an instruction has been developed on how to treat drug-induced hepatitis. The sequence of all actions can lead to complete recovery of the patient:
- Cancellation of the medicinal product. It is important to find a less toxic drug instead of the previous one. It is not recommended to do it yourself.
- Detoxification therapy, which will help to purify the liver and remove from the body all toxic remnants of the drug.
- After this, it is necessary to carry out restorative therapy. Usually it is done with the help of hepatoprotectors, which can improve metabolism in liver cells.
- Conducting symptomatic therapy( according to indications).
For this disease, treatment should be carried out with strict adherence to the diet. Diet - table number 5, which is assigned to all hepatic patients and includes:
- Fractional meals.
- Restriction of fatty, spicy and fried foods.
- Exclusion from the diet of alcoholic beverages.
- Eating foods rich in carbohydrates.
- Additional cellular nutrition( amino acids, vitamins, minerals).
Prevention of drug-induced hepatitis
Since most drug-induced hepatitis occurs in drug users and alcoholics in treatment, it is very important to monitor liver status during the therapy. For this, weekly monitoring of the level of liver enzymes is performed. After discharge, it is recommended to monitor the blood enzymes on a monthly basis.