Impact of Drugs to Induce Liver Injury

Abstract

Drug-induced liver injury (DILI) is an unintended effect on the liver of medications and dietary
supplements, which can be serious eventually leading to acute liver failure, transplantation, and death. DILI is
an uncommon, but potentially fatal, cause of liver disease that is associated with prescription medications, OTC
drugs, and herbal and dietary supplements (HDS). It can occur through direct toxicity from the drug or a
reactive metabolite or redness of cells through immune or other idiosyncratic mechanisms. DILI has been
categorized as direct or idiosyncratic but indirect liver injury has emerged as a third type of drug-induced liver
injury. Alcohol consumption has been proposed as a risk factor for DILI from medications, but there is
insufficient evidence to support this. Depending on the duration of injury and the histological location of
damage, DILI is categorized as acute or chronic, and either as hepatitis, cholesterol, or a mixed pattern of
injury. These changes can be due to liver disorders that are unique to pregnancy or as an acute or chronic liver
disease occurring coincidentally in pregnancy. These fall into main depending on their associated with or
without pre-eclampsia, such as hyperemesis gravidarum intra-hepaticcholestasis during pregnancy, and acute
fatty liver of pregnancy.