What Are the Different Kinds of Hepatitis Medicines?

Drug-induced hepatitis refers to liver damage caused by drugs or / and its metabolites. Healthy people who have no previous history of hepatitis or patients who have had serious diseases originally have different degrees of liver damage after using a certain drug. It can be clinically manifested as various acute and chronic hepatitis, and can recover on its own after stopping the drug. It can be manifested as hepatocyte necrosis, cholestasis, intracellular microlipid deposition or chronic hepatitis, cirrhosis, etc. Severe cases may be life-threatening and require active treatment and rescue. It can occur when the drug is overdose, or it can occur under normal dosage. At present, there are more than 30,000 drugs and health products in our daily life, and more than 1,000 drugs can cause this disease. Therefore, drug-induced hepatitis has become a serious public health problem that cannot be ignored.

Basic Information

English name: drug-induced hepatitis
Visiting department: Gastroenterology
Common locations: liver

Common causes: Direct toxic effects of drugs and their intermediate metabolites on the liver, drug allergies
Common symptoms: Liver discomfort, bloating, loss of appetite, nausea, fatigue, etc.
Contagious: no

Causes of drug-induced hepatitis

1. The direct toxic effects of drugs and their intermediate metabolites on the liver.

2. The body's allergic reactions to drugs, or allergic reactions to intermediate metabolites produced by drug-specific reactions, are also the main causes of drug-induced hepatitis.

Clinical manifestations of drug-induced hepatitis

Drug-induced hepatitis can manifest as any type of acute or chronic liver disease currently known, in which acute liver injury accounts for more than 90% of the reported cases, and a small number of patients can develop life-threatening fulminant or severe liver failure. If the acute drug-type hepatitis is of the hepatocyte type, it can be manifested as hepatitis type or fatty liver type. The clinical features are fatty liver, azotemia, and pancreatitis. It can also be manifested as intrahepatic cholestatic drug-type hepatitis Including simple cholestasis, cholestasis with inflammatory hepatitis, and mixed drug-induced hepatitis have both hepatitis and cholestasis. Chronic drug-induced hepatitis can be chronic active hepatitis or steatohepatitis, cholestatic hepatitis, and other manifestations. Clinical symptoms may include liver discomfort, bloating, loss of appetite, nausea, and fatigue. Laboratory tests, the earliest and most common are elevated serum transaminase, jaundice, increased blood bilirubin, and other serum alkaline phosphatase and glutamyl transpeptidase.

Drug-induced hepatitis test

Laboratory inspection

(1) Liver function test.

(2) Serological examination (detection of virus-specific markers, which is helpful for typing of viral hepatitis).

(3) Other related tests (blood routine, renal function, protein, fat and glucose metabolism, serum immunological tests, etc.).

2. Imaging examination

Including abdominal ultrasound, CT, magnetic resonance examination.

3. Pathological examination of liver puncture

It is of great value in the diagnosis of various types of hepatitis. The correct data can be obtained for the etiology, etiology, inflammatory activity, and fibrosis of hepatitis, which is conducive to clinical diagnosis and differential diagnosis.

Diagnosis of drug-induced hepatitis

Judgment is mainly based on medication history, clinical symptoms, blood signs, liver function, etiological markers, and effects after discontinuation of treatment.

Drug-induced hepatitis treatment

Treatment principles include the immediate discontinuation of relevant or suspicious drugs (the key to treatment), the promotion of drug removal of liver damage and the application of antidote, the application of hepatocyte protectants, and the treatment of liver failure.

1. Immediately discontinue medications related to or suspected liver damage.

2. Bed rest, combined with diet therapy (same as viral hepatitis diet), supplement sufficient calories, sufficient protein, multivitamins such as vitamins C, E, B, etc. to facilitate liver cell repair and regeneration.

3. For deep jaundice, intravenous drip of glucose and vitamin C, and Yin Zhihuang, a traditional Chinese medicine, should be given intravenously to maintain electrolyte balance.

4. Give the corresponding antidote according to the drug situation. Patients with acute poisoning can take gastric lavage, catharsis, activated carbon adsorption and other measures to eliminate gastrointestinal residual drugs, and use hemodialysis, intraperitoneal dialysis, hemoperfusion, plasma exchange and other methods to quickly remove drugs from the body; antidote applications: including non-specific Heterosexides such as glutathione, N-acetylcysteine, sodium thiosulfate, steroid hormones, UDCA, S-adenosylmethionine, polyene phosphatidylcholine, etc. and specific chelating agents such as dimercaptopropanol , Penicillamine, thiosuccinic acid, thioethylamine, calcium sodium edetate, and the like.

5. Patients with obvious cholestasis can try prednisone treatment. According to the clinical situation of the patient, appropriate anti-inflammatory and liver-protective drugs can be selected, including glycyrrhizic acid preparations and silymarin based on anti-inflammatory and liver-protection. The main tiopronin, reduced glutathione, N-acetylcysteine, protects the polyene phosphatidylcholine based on hepatocyte membrane, promotes hepatocyte metabolism: adenosylmethionine, glucuronide, complex coenzyme Potassium and magnesium aspartate, hepatocyte growth factors that promote liver cell repair and regeneration, adenosylmethionine, potassium aspartate, and ursodeoxycholic acid, which promote bilirubin and bile acid metabolism

6. Complicated fulminant liver failure should be treated according to the principle of fulminant hepatitis. Artificial liver or artificial kidney clearance drugs can be used, and special antidote can be used. Paracetamol causes liver necrosis, which can be detoxified with N-cysteine acetate. Liver transplantation may be the only effective treatment for patients with severe disease and rapid progress.

Drug-induced hepatitis prevention

The prevention of drug-induced hepatitis is important. Clinicians should be familiar with the properties and side effects of the drugs used, and try to use less or no drugs that have toxic effects on the liver. Patients with a history of drug allergies or allergies should be cautious when using drugs.