Drug Induced Liver toxicity

>4 g of APAP
intrinsic or idiosyncratic?

dose dependent
intrinsic or idiosyncratic?

ellicited in all individuals
intrinsic or idiosyncratic?

reproducible in all animal experiments.
intrinsic or idiosyncratic?

distinctive histologic pattern for any given drug.
intrinsic or idiosyncratic?

predictable appearance of lesions and usually a brief latent period.
intrinsic or idiosyncratic?

no extrahepatic manifestations of hypersensitivity.
intrinsic or idiosyncratic?

dose independent.
intrinsic or idiosyncratic?

phenytoin.
intrinsic or idiosyncratic?

small % of exposed individuals are affected.
intrinsic or idiosyncratic?

variable histologic pattern of lesions intrinsic or idiosyncratic?

cannot be reproduced in animals.
intrinsic or idiosyncratic?

appearnce of lesions has no temporal relationship to the start of the drug therapy.
intrinsic or idiosyncratic?

can have extrahepatic manifestation.
intrinsic or idiosyncratic?

amiodarone morphology

androgens morphology

aspirin morphology

oral contraceptives morphology

fluoroquinolines morphology

lovastatin morphology

methotrexate morphology

phenytoin morphology

valproic acid morphology

vitamin A morphology

Bactrim morphology

sulfonamide morphology

isoniazid morphology

carbamazepine morphology

drugs that cause phospholipidosis

drugs that cause steatosis

drugs that cause cholestasis

drugs that cause necrosis

drugs associated with hypersensitivity (rash, liver tox)

This condition is NOT hepatocellular.
A) necrosis
B) cholestatic
C) steatosis

which has higher AST and ALT elevation?
necrosis vs. steatosis

alk phos is associated with...
A) necrosis
B) steatosis
C) cholestatic

ALT is elevated in...
A) cholestatic
B) steatosis
C) necrosis

bilirubin is elevated in ...
A) steatosis
B) necrosis
C) cholestatic

5-nucleotidase is elevated in..
A) steatosis
B) cholestatic
C) necrosis

AST is elevated in ...
A) steatosis
B) cholestatic
C) necrosis

lactate dehydrogenase is elevated in...
A) steatosis
B) cholestasis
C) necrosis

"antidote" therapy for methotrexate?

"antidote" therapy for immune mediated liver issue.

"antidote" therapy for APAP.

"antidote" therapy for steatosis.

"antidote" therapy for pruritis

"antidote" therapy for valproic acid

"antidote" therapy for ascites

idiosyncratic reaction of
isoniazid, trazodone, diclofenac, nefazodone, venlafaxine, lovastatin

idiosyncratic reaction of chlorpromazine, estrogen, erythromycin

idiosyncratic reaction of halothane, phenytoin, sulfamethoxazole

idiosyncratic reaction of diltiazen, sulfa drugs, quinidine

idiosyncratic reaction of didanosine, tetracycline, actylsalicylic acid, valproic acid

idiosyncratic reaction of amiodarone, tamoxifen

idiosyncratic reaction of nitrofurantoin, methyldopa, lovastatin, minocycline

idiosyncratic reaction of methotrexate, excess vitamin A

idiosyncratic reaction of nicotinic acid, cocaine, methylenedioxymethamphetamine

idiosyncratic reaction of oral contraceptive, androgen

idiosyncratic reaction of augmentin, carbamazepine, herbs, cyclosorine, methimazole, troglitazone

APAP increased dose effect

amiodarone cumulative dose effect

cocaine increased dose effect

cyclosporine increased dose effect

methotrexate increased/cumulative dose effect

niacin increased dose effect

OCP cumulative dose effect