DRUG-INDUCED LIVER-DISEASE

This review discusses the recent literature on drug-induced liver dise ase, a common and often underappreciated cause of liver injury. There continues to be very little insight into the pathogenesis of hepatotox icity for most drugs. Acetaminophen is one of the few drugs for which the mechanisms of liver injury are reasonably well understood. With an understanding of these mechanisms, new reports have identified severa l factors that can increase the severity or risk of developing acetami nophen-associated liver injury. Other studies have improved our unders tanding of the mechanisms by which halogenated anesthetics cause liver injury. This information has made it possible to correlate the pathwa y of metabolism of these agents with their incidence of hepatotoxicity and even to potentially predict the risk of liver injury with new ane sthetics. Antibiotics continue to be one of the most commonly used med ications and one of the more common causes of drug-induced liver disea se. Recent reports stress the importance of these drugs as potential c auses of liver injury and highlight the frequency with which some anti biotics cause hepatotoxicity, Finally, several case reports of other d rugs noted to cause liver disease are reviewed.