HEPATOTOXICITY OF ANALGESICS AND ANTIINFLAMMATORY AGENTS

Nearly all analgesic and anti-inflammatory agents have the potential f or hepatic injury. Most nonsteroidal anti-inflammatory drugs (NSAIDs) produce injury in an unpredictable fashion by way of an idiosyncratic (immunologic versus metabolic) mechanism, whereas acetaminophen and as pirin are more predictable because they produce injury in a dose-depen dent manner by way of intrinsic toxicity. Both acetaminophen and aspir in may produce hepatotoxicity despite therapeutic intent. This article discusses specific NSAIDs available in the United States and abroad a nd their associated hepatotoxicity and carefully considers acetaminoph en-related hepatotoxicity reviewing risk factors for injury, clinical features, prognosis, and management.