Risk Factors
This non-modifiable risk factor increases susceptibility to DILI due to age-related hepatic changes.
What is age?
High daily dose and lipophilicity are drug-related risk factors for this adverse event.
What is DILI?
This over-the-counter analgesic is the most common cause of acute liver failure in the U.S.
What is acetaminophen (APAP)?
This is the first and most crucial step in managing suspected DILI.
What is identifying and discontinuing the offending drug?
These enzymes (ALT, AST) are elevated in hepatocellular injury.
What are transaminases?
This biological characteristic affects enzyme expression and may explain higher DILI risk in females.
What is gender?
This mechanism leads to hepatocellular injury through free radical generation.
What is oxidative stress?
This anticonvulsant causes mitochondrial toxicity and is a known cause of microvesicular steatosis.
What is valproic acid?
This antidote replenishes glutathione and is used in acetaminophen toxicity.
What is N-acetylcysteine (NAC)?
This specific biomarker forms when APAP’s toxic metabolite binds liver proteins.
What is APAP-CYS (acetaminophen–cysteine adduct)?
This lifestyle choice can deplete glutathione stores and increase the risk for APAP-induced liver injury.
What is alcohol consumption?
This organelle's dysfunction impairs ATP production and can trigger cell death pathways in hepatocytes.
What is mitochondrial dysfunction?
This antiepileptic can trigger hypersensitivity reactions and is associated with DILI.
What is carbamazepine?
This class of medications may be used in autoimmune-like DILI.
What are immunosuppressants (e.g., glucocorticoids)?
A rising level of this yellow pigment often signals worsening liver excretion function.
What is bilirubin?
Variants in CYP2E1 or NAT2 are examples of this type of genetic contributor to DILI.
What are drug metabolism genetic polymorphisms?
This type of intracellular stress results from the accumulation of misfolded proteins in hepatocytes.
What is ER (endoplasmic reticulum) stress?
This antibiotic combination is among the most common causes of idiosyncratic DILI in Western countries.
What is amoxicillin-clavulanate (Augmentin)?
This agent, used in cholestatic DILI, improves bile flow and may have cytoprotective effects.
What is ursodeoxycholic acid (UDCA)?
This coagulation test reflects liver synthetic function and may predict poor prognosis in acute liver failure.
What is INR (International Normalized Ratio)?
Inherited defects in this hepatic protection pathway can impair detoxification of reactive oxygen species.
What are antioxidant defense system genetic polymorphisms?
Inhibition of this bile acid transporter may cause cholestatic liver injury.
What is BSEP (bile salt export pump) inhibition?
This first-line tuberculosis drug requires routine liver monitoring due to DILI risk.
What is isoniazid?
This is the final option when medical management fails and liver function declines severely.
What is liver transplantation?
This enzyme is elevated more in cholestatic DILI than hepatocellular DILI.
What is alkaline phosphatase (ALP)?