RT Book, Section A1 Kirchain, William R. A1 Allen, Rondall E. A2 DiPiro, Joseph T. A2 Talbert, Robert L. A2 Yee, Gary C. A2 Matzke, Gary R. A2 Wells, Barbara G. A2 Posey, L. Michael SR Print(0) ID 1145220291 T1 Drug-Induced Liver Disease T2 Pharmacotherapy: A Pathophysiologic Approach, 10e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781259587481 LK accesspharmacy.mhmedical.com/content.aspx?aid=1145220291 RD 2024/03/28 AB KEY CONCEPTS Through its normally functioning enzymes and processes the liver often causes a drug to become toxic through a process known as bioactivation. Drug-induced liver disease (DILD) can have many different clinical presentations: idiosyncratic reactions, allergic hepatitis, toxic hepatitis, chronic active toxic hepatitis, toxic cirrhosis, and liver vascular disorders. The mechanisms of DILD are diverse, representing many phases of biotransformation, and are susceptible to genetic polymorphism. The assessment of a possible liver injury caused by drugs should include what is known in the literature, the timing involved, the clinical course, and, always, an exploration for preexisting conditions that may have encouraged the lesion’s development. Liver enzyme assays in serum can help to determine if a particular type of liver damage is present. Monitoring for DILD must be tailored to the drug and the patient’s potential risk factors.