Materiały źródłowe

• #1 Toxic Hepatitis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/toxic-hepatitis

  The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation. However, they are considered candidates for transplantation only if they have been completely abstinent from alcohol and in a treatment program for a minimum of six months.

• #2 Toxic Hepatitis | UCSF Department of Surgery

  https://hpbsurgery.ucsf.edu/condition/toxic-hepatitis

  The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] In the case of alcohol-related liver damage, joining a program such as Alcoholics Anonymous and/or enrolling in a treatment/rehabilitation program is highly recommended and may be required. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation. However, they are considered candidates for transplantation only if they have been completely abstinent from alcohol and in a treatment program for a minimum of six months.

• #3 Treatment for liver toxicity: Options and recovery

  https://www.medicalnewstoday.com/articles/liver-toxicity-treatment

  The aims of liver toxicity treatment are to manage the symptoms, regenerate damaged liver cells, and prevent further damage. Options include medication, supportive therapy, emergency care, liver transplant, and stopping exposure to the toxin. […] Depending on the cause and severity, medical treatment can sometimes reverse the damage to the liver that has occurred. A persons symptoms may also improve once exposure to the toxin has stopped. […] A person with permanent liver damage will require a liver transplant to restore liver function. Although treatment can sometimes reverse acute liver failure, a liver transplant may also be the only cure in many instances. […] According to a study in the Journal of Hepatology, discontinuing the implicated drug or agent is the first step in managing liver toxicity. The researchers note that in most cases of liver toxicity, people recover immediately without further treatment after stopping the exposure.

• #4 Toxic hepatitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/toxic-hepatitis

  Doctors will work to determine what’s causing your liver damage. Sometimes it’s clear what’s causing your symptoms, and other times it takes more detective work to pinpoint a cause. In most cases, stopping exposure to the toxin causing liver inflammation will reduce the signs and symptoms you experience. […] Treatments for toxic hepatitis may include: […] Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. […] Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose.

• #5 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #6 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis treatment depends on the extent of damage to your liver, but you may be able to help your liver heal and/or protect the health of your liver by making lifestyle changes. […] Toxic hepatitis treatment depends on the extent of damage to your liver. After checking your liver, your healthcare provider may recommend that you: Avoid taking certain medications or supplements that may cause liver toxicity. Stop drinking alcohol. Talk to your supervisor about changing duties if you’re exposed to chemicals in your workplace. Wear protective equipment if you work with certain chemicals. […] In many instances, toxic hepatitis is curable. Your liver can replace damaged cells over time, reversing the damage that occurred. But if you have advanced liver disease like cirrhosis, you may be at risk for liver failure. Your care team may talk to you about liver transplantation.

• #7 Toxic hepatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/toxic-hepatitis/symptoms-causes/syc-20352202

  Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. […] The only treatment for chronic liver failure is to replace your liver with a healthy one from a donor (liver transplant). […] Because it’s not possible to know how you’ll react to a particular medication, toxic hepatitis can’t always be prevented. But you may reduce your risk of liver problems if you: […] Take precautions with chemicals. If you work with or use hazardous chemicals, take all necessary precautions to protect yourself from exposure. If you do come in contact with a harmful substance, follow the guidelines in your workplace, or call your local emergency services or your local poison control center for help.

• #8 Toxic Hepatitis | Liver Canada

  https://liver.ca/toxic-hepatitis/

  Discover management and treatment strategies for toxic hepatitis. […] Treatment for toxic hepatitis focuses on limiting exposure to toxic substances and managing symptoms. These treatment methods include: Avoiding exposure to toxic substances, Maintaining a healthy lifestyle (balanced diet, daily exercise, quality sleep), In some cases if a patient has severe liver damage, a liver transplant may be necessary.

• #9 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis treatment depends on the extent of damage to your liver, but you may be able to help your liver heal and/or protect the health of your liver by making lifestyle changes. […] Toxic hepatitis treatment depends on the extent of damage to your liver. After checking your liver, your healthcare provider may recommend that you: Avoid taking certain medications or supplements that may cause liver toxicity. Stop drinking alcohol. Talk to your supervisor about changing duties if you’re exposed to chemicals in your workplace. Wear protective equipment if you work with certain chemicals. […] In many instances, toxic hepatitis is curable. Your liver can replace damaged cells over time, reversing the damage that occurred. But if you have advanced liver disease like cirrhosis, you may be at risk for liver failure. Your care team may talk to you about liver transplantation.

• #10 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis recovery time depends on: How long you’ve had the condition. The damage to your liver. If damage is mild to moderate, your liver may take a few weeks or months to replace the damaged cells and heal. […] Talk to your healthcare provider about the causes of liver toxicity and how you can improve your liver’s health. If you have severe liver damage from toxic hepatitis, your healthcare provider can talk with you about treatment options to restore your health.

• #11

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/toxic-hepatitis

  Toxic hepatitis Last Updated on May 15, 2024. Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] The only treatment for chronic liver failure is to replace your liver with a healthy one from a donor (liver transplant). […] Treatments for toxic hepatitis may include: Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose. Emergency care. For people who overdose on a toxic medication, emergency care is essential. People who overdose on certain medications other than acetaminophen may benefit from treatments to remove the offending medication from the body or reduce its toxic effect. […] Liver transplant. When liver function is severely impaired, a liver transplant may be the only option for some people. A liver transplant is an operation to remove your diseased liver and replace it with a healthy liver from a donor.

• #12 Toxic hepatitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/toxic-hepatitis

  Doctors will work to determine what’s causing your liver damage. Sometimes it’s clear what’s causing your symptoms, and other times it takes more detective work to pinpoint a cause. In most cases, stopping exposure to the toxin causing liver inflammation will reduce the signs and symptoms you experience. […] Treatments for toxic hepatitis may include: […] Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. […] Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose.

• #13 Drug-induced liver injury – UF Health

  https://ufhealth.org/conditions-and-treatments/drug-induced-liver-injury

  The only specific treatment for most cases of liver damage caused by taking a drug is to stop taking the drug that caused the problem. […] However, if you took high doses of acetaminophen, you should get treated for liver injury in the emergency department or other acute treatment setting as soon as possible as there is a specific antidote for acetaminophen poisoning. […] If symptoms are severe, you should rest and avoid heavy exercise, alcohol, acetaminophen, and any other substances that might harm the liver. You may need to get fluids through a vein if nausea and vomiting are severe.

• #14 Toxic Hepatitis | Health & Human Services

  https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/toxic-hepatitis

  Diagnosis of toxic hepatitis caused by chemical exposure requires a thorough assessment of the patient, including clinical signs and symptoms, laboratory testing, an exposure history, and possible liver imaging and biopsy. […] If a person is suspected of having, or has been diagnosed with toxic hepatitis, exposure to the chemical or drug(s) identified as the possible causative agent should be immediately discontinued. Rest is indicated if symptoms are severe. If nausea and vomiting are significant, hospitalization and intravenous fluids may be advised. People with acute hepatitis should avoid physical exertion, alcohol, and any hepatotoxic substances. Consultation with a medical toxicologist should be considered. […] Liver inflammation usually subsides within days or weeks after exposure to the chemical or drug is stopped. In severe cases, liver failure can occur. The overall mortality rate for drug-induced liver injury is around 5 percent.

• #15 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Early recognition of drug-induced liver reactions is essential to minimizing injury. […] Monitoring hepatic enzyme levels is appropriate and necessary with a number of agents, especially with those that lead to overt injury. […] For drugs that produce liver injury unpredictably, biochemical monitoring is less useful. […] ALT values are more specific than AST values. […] ALT values that are within the reference range at baseline and rise 2- to 3-fold should lead to enhanced vigilance in terms of more frequent monitoring. […] ALT values 4-5 times higher than the reference range should lead to prompt discontinuation of the drug. […] The general recommendations for evaluating and monitoring potential drug-induced hepatotoxicity may not be suitable for all situations and should be modified for special populations, such as people with preexisting liver disease or malignancies, and in light of accumulating data.

• #16

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/toxic-hepatitis

  Toxic hepatitis Last Updated on May 15, 2024. Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] The only treatment for chronic liver failure is to replace your liver with a healthy one from a donor (liver transplant). […] Treatments for toxic hepatitis may include: Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose. Emergency care. For people who overdose on a toxic medication, emergency care is essential. People who overdose on certain medications other than acetaminophen may benefit from treatments to remove the offending medication from the body or reduce its toxic effect. […] Liver transplant. When liver function is severely impaired, a liver transplant may be the only option for some people. A liver transplant is an operation to remove your diseased liver and replace it with a healthy liver from a donor.

• #17 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #18 Toxic hepatitis | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20166943/

  Find out about symptoms and treatment for toxic hepatitis liver inflammation caused by exposure to certain substances, such as alcohol or medications. […] Toxic hepatitis occurs when your liver develops inflammation because of exposure to a toxic substance. Toxic hepatitis may also develop when you take too much of a prescription or over-the-counter medication. […] Treatments for toxic hepatitis may include: […] Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. […] Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose.

• #19 Hepatitis treatment options | Liver Disease News

  https://liverdiseasenews.com/hepatitis-treatment-options/

  Toxic hepatitis occurs when chemicals or drugs damage the liver, leading to inflammation. Toxic hepatitis can be caused by alcohol and other recreational drugs, as well as certain industrial chemicals and herbal supplements. Some medications, including acetaminophen (sold as Tylenol, among others), also can cause toxic hepatitis especially at high doses. […] Treating toxic hepatitis generally involves identifying the substance that is causing liver damage, and then stopping exposure (e.g., abstaining from alcohol use). Usually, the liver is able to heal itself once the toxin is eliminated, but this recovery can take varying amounts of time depending on how much damage has accumulated. While the liver heals, supportive care such as hydration or pain relief may be given. […] In instances of toxic hepatitis due to acetaminophen (an analgesic and antipyretic agent, to reduce pain and fever), a medication called N-acetylcysteine (NAC) may be given to help remove the toxin from the body. NAC is almost 100% effective if it’s given within eight hours of taking a toxic dose of acetaminophen.

• #20 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  No specific treatment is indicated for drug-induced hepatic disease. […] Treatment is largely supportive and based on symptomatology. […] The first step is to discontinue the suspected drug. […] Specific therapy against acetaminophen-induced liver injury is limited to the use of N-acetylcysteine in the early phases. […] L-carnitine is potentially valuable in cases of valproate toxicity. […] In non-acetaminophen-induced acute liver failure, N-acetylcysteine has been shown to be efficacious at improving overall survival, post-transplant survival, and survival without transplant while decreasing the overall length of hospital stays. […] In general, corticosteroids have no definitive role in treatment. […] They may suppress the systemic features associated with hypersensitivity or allergic reactions.

• #21 An Update on Treatment of Drug-Induced Liver Injury

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4521262/

  Lee et al. performed an eight year prospective, double-blind, placebo control trial of N-acetylcysteine (NAC) for patients with acute liver failure not secondary to acetaminophen overdose. […] At this time, NAC therapy can and should be considered for patients who are presenting with acute liver failure. […] In addition, a small uncontrolled study performed by Wree et al. compared steroid pulse therapy with steroid step down therapy, both in combination with ursodeoxycholic acid, in the treatment of drug-induced liver injury, including patients with hepatocellular and/or cholestatic injury. […] Patients who present with fever, rash, and eosinophilia should be considered for a diagnosis of drug-induced autoimmune hepatitis. If the DILI is severe, corticosteroid therapy should be considered as studies have demonstrated normalization of biochemical tests within six months. […] Finally, patients who present with a cholestatic picture may complain of intense pruritus. Treatment options for these patients include emollients, hydroxyzine, diphenhydramine, bile acid resins, and rifampicin.

• #22 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #23 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  No specific treatment is indicated for drug-induced hepatic disease. […] Treatment is largely supportive and based on symptomatology. […] The first step is to discontinue the suspected drug. […] Specific therapy against acetaminophen-induced liver injury is limited to the use of N-acetylcysteine in the early phases. […] L-carnitine is potentially valuable in cases of valproate toxicity. […] In non-acetaminophen-induced acute liver failure, N-acetylcysteine has been shown to be efficacious at improving overall survival, post-transplant survival, and survival without transplant while decreasing the overall length of hospital stays. […] In general, corticosteroids have no definitive role in treatment. […] They may suppress the systemic features associated with hypersensitivity or allergic reactions.

• #24 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #25 An Update on Treatment of Drug-Induced Liver Injury

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4521262/

  Lee et al. performed an eight year prospective, double-blind, placebo control trial of N-acetylcysteine (NAC) for patients with acute liver failure not secondary to acetaminophen overdose. […] At this time, NAC therapy can and should be considered for patients who are presenting with acute liver failure. […] In addition, a small uncontrolled study performed by Wree et al. compared steroid pulse therapy with steroid step down therapy, both in combination with ursodeoxycholic acid, in the treatment of drug-induced liver injury, including patients with hepatocellular and/or cholestatic injury. […] Patients who present with fever, rash, and eosinophilia should be considered for a diagnosis of drug-induced autoimmune hepatitis. If the DILI is severe, corticosteroid therapy should be considered as studies have demonstrated normalization of biochemical tests within six months. […] Finally, patients who present with a cholestatic picture may complain of intense pruritus. Treatment options for these patients include emollients, hydroxyzine, diphenhydramine, bile acid resins, and rifampicin.

• #26 THE COURSE OF TOXIC HEPATITIS IN LEUKEMIC PATIENTS AT THE STAGE OF SUPPORT THERAPY. | Hematology, Transfusion and Cell Therapy

  https://www.htct.com.br/en-the-course-of-toxic-hepatitis-articulo-S2531137922013888

  One of the main tasks in the treatment of acute leukemia is to prevent the development of complications of chemotherapy, as well as the timely choice of the correct tactics for the treatment of complications. […] Our task was to conduct research work in this area, and to study toxic liver lesions in patients with leukemia. […] Objective: To study the frequency of toxic liver damage in children with acute leukemia during support therapy, to choose treatment tactics according to the severity of toxic hepatitis. […] In the mild form of hepatitis, patients were prescribed intravenous administration of Riboksin+Aevit (orally) for 10-14 days, or alternatively, per os Ursobil+Aevit. […] The administration of intravenous adeomethionine (Heptral) in the form of monotherapy for 8-12 days allowed continuous reinduction courses.

• #27 Treatment of toxic hepatitis in COVID-19 patients – Maev – Terapevticheskii arkhiv

  https://ter-arkhiv.ru/0040-3660/article/view/121853

  The aim of the present study is to increase the effectiveness of the treatment of toxic hepatitis in patients who have undergone COVID-19. […] The use of drugs with hepatoprotective effect in the form of monotherapy in groups 1 (UDCA) and 2 (ademethionine) showed a low therapeutic effect with positive dynamics of clinical and laboratory indicators of toxic hepatitis activity. The use of combined treatment in group 3 (UDCA and ademethionine) demonstrated the maximum therapeutic effect, pronounced positive dynamics in the form of normalization of clinical and laboratory indicators of toxic hepatitis activity.

• #28 Treatment of toxic hepatitis in COVID-19 patients – Maev – Terapevticheskii arkhiv

  https://ter-arkhiv.ru/0040-3660/article/view/121853

  The aim of the present study is to increase the effectiveness of the treatment of toxic hepatitis in patients who have undergone COVID-19. […] The use of drugs with hepatoprotective effect in the form of monotherapy in groups 1 (UDCA) and 2 (ademethionine) showed a low therapeutic effect with positive dynamics of clinical and laboratory indicators of toxic hepatitis activity. The use of combined treatment in group 3 (UDCA and ademethionine) demonstrated the maximum therapeutic effect, pronounced positive dynamics in the form of normalization of clinical and laboratory indicators of toxic hepatitis activity.

• #29 The course of toxic hepatitis at the stage of treatment consolidation acute leukemia in children | Hematology, Transfusion and Cell Therapy

  https://www.htct.com.br/en-the-course-toxic-hepatitis-at-articulo-S2531137920302583

  Objective: Toxic hepatitis occupies a special place among the complications of chemotherapy in the treatment of patients with acute leukemia. The research work we have presented is devoted to studying the frequency of toxic hepatitis and the choice of treatment tactics for children who are at the stage of consolidating acute leukemia. […] Conclusion: In the mild form of hepatitis from the intravenous use of Essentiale forte and Riboxin against the background of ongoing chemotherapy, a positive effect was obtained. With moderate severity, intravenous administration of Adeomethionine preparations (Heptral/Legend) in combination with Aevit per os turned out to be more effective. In 4 patients, upon transition to a severe form in the last course of consolidation, along with these drugs, ursodeoxycholic acid (Ursobil)+enhanced detoxification therapy was prescribed, which led to a complete recovery. After the treatment of toxic hepatitis, all patients with moderate and severe form, for the purpose of prevention, was prescribed combination therapy with Ursobil+Aevit+Lipoic acid, which gave a long-term positive effect.

• #30 THE COURSE OF TOXIC HEPATITIS IN LEUKEMIC PATIENTS AT THE STAGE OF SUPPORT THERAPY. | Hematology, Transfusion and Cell Therapy

  https://www.htct.com.br/en-the-course-of-toxic-hepatitis-articulo-S2531137922013888

  One of the main tasks in the treatment of acute leukemia is to prevent the development of complications of chemotherapy, as well as the timely choice of the correct tactics for the treatment of complications. […] Our task was to conduct research work in this area, and to study toxic liver lesions in patients with leukemia. […] Objective: To study the frequency of toxic liver damage in children with acute leukemia during support therapy, to choose treatment tactics according to the severity of toxic hepatitis. […] In the mild form of hepatitis, patients were prescribed intravenous administration of Riboksin+Aevit (orally) for 10-14 days, or alternatively, per os Ursobil+Aevit. […] The administration of intravenous adeomethionine (Heptral) in the form of monotherapy for 8-12 days allowed continuous reinduction courses.

• #31 THE COURSE OF TOXIC HEPATITIS IN LEUKEMIC PATIENTS AT THE STAGE OF SUPPORT THERAPY. | Hematology, Transfusion and Cell Therapy

  https://www.htct.com.br/en-the-course-of-toxic-hepatitis-articulo-S2531137922013888

  In severe hepatitis, chemotherapy was suspended, and patients were prescribed intravenous adeomethionine (Heptral) in combination with oral Ursobil+Aevit for 10-14 days, and along with this detoxification therapy was carried out in parallel. […] Such treatment gave an improvement in clinical and laboratory parameters.

• #32 The course of toxic hepatitis at the stage of treatment consolidation acute leukemia in children | Hematology, Transfusion and Cell Therapy

  https://www.htct.com.br/en-the-course-toxic-hepatitis-at-articulo-S2531137920302583

  Objective: Toxic hepatitis occupies a special place among the complications of chemotherapy in the treatment of patients with acute leukemia. The research work we have presented is devoted to studying the frequency of toxic hepatitis and the choice of treatment tactics for children who are at the stage of consolidating acute leukemia. […] Conclusion: In the mild form of hepatitis from the intravenous use of Essentiale forte and Riboxin against the background of ongoing chemotherapy, a positive effect was obtained. With moderate severity, intravenous administration of Adeomethionine preparations (Heptral/Legend) in combination with Aevit per os turned out to be more effective. In 4 patients, upon transition to a severe form in the last course of consolidation, along with these drugs, ursodeoxycholic acid (Ursobil)+enhanced detoxification therapy was prescribed, which led to a complete recovery. After the treatment of toxic hepatitis, all patients with moderate and severe form, for the purpose of prevention, was prescribed combination therapy with Ursobil+Aevit+Lipoic acid, which gave a long-term positive effect.

• #33 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #34

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/toxic-hepatitis

  Toxic hepatitis Last Updated on May 15, 2024. Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] The only treatment for chronic liver failure is to replace your liver with a healthy one from a donor (liver transplant). […] Treatments for toxic hepatitis may include: Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose. Emergency care. For people who overdose on a toxic medication, emergency care is essential. People who overdose on certain medications other than acetaminophen may benefit from treatments to remove the offending medication from the body or reduce its toxic effect. […] Liver transplant. When liver function is severely impaired, a liver transplant may be the only option for some people. A liver transplant is an operation to remove your diseased liver and replace it with a healthy liver from a donor.

• #35 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Management of protracted drug-induced cholestasis is similar to that for primary biliary cirrhosis. […] Cholestyramine may be used for alleviation of pruritus. […] Ursodeoxycholic acid may be used. […] Lastly, consulting a hepatologist is also helpful. […] No specific antidote is available for the vast majority of hepatotoxic agents. […] Emergency liver transplantation has utility in the setting of drug-induced fulminant hepatic injury. […] Considering early liver transplantation is important. […] The Model for End-Stage Liver Disease score can be used to evaluate short-term survival in an adult with end-stage liver disease. […] This can help stratify candidates for liver transplantation. […] Another criterion commonly used for liver transplantation is the Kings College criteria.

• #36

  https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/toxic-hepatitis

  Toxic hepatitis Last Updated on May 15, 2024. Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] The only treatment for chronic liver failure is to replace your liver with a healthy one from a donor (liver transplant). […] Treatments for toxic hepatitis may include: Supportive care. People with severe symptoms are likely to receive supportive therapy in the hospital, including intravenous fluids and medication to relieve nausea and vomiting. Your doctor will also monitor for liver damage. Medication to reverse liver damage caused by acetaminophen. If your liver damage was caused by an overdose of acetaminophen, you’ll receive a chemical called acetylcysteine right away. The sooner this medication is administered, the greater the chance of limiting liver damage. It’s most effective if administered within 16 hours of the acetaminophen overdose. Emergency care. For people who overdose on a toxic medication, emergency care is essential. People who overdose on certain medications other than acetaminophen may benefit from treatments to remove the offending medication from the body or reduce its toxic effect. […] Liver transplant. When liver function is severely impaired, a liver transplant may be the only option for some people. A liver transplant is an operation to remove your diseased liver and replace it with a healthy liver from a donor.

• #37 Treatment for liver toxicity: Options and recovery

  https://www.medicalnewstoday.com/articles/liver-toxicity-treatment

  The aims of liver toxicity treatment are to manage the symptoms, regenerate damaged liver cells, and prevent further damage. Options include medication, supportive therapy, emergency care, liver transplant, and stopping exposure to the toxin. […] Depending on the cause and severity, medical treatment can sometimes reverse the damage to the liver that has occurred. A persons symptoms may also improve once exposure to the toxin has stopped. […] A person with permanent liver damage will require a liver transplant to restore liver function. Although treatment can sometimes reverse acute liver failure, a liver transplant may also be the only cure in many instances. […] According to a study in the Journal of Hepatology, discontinuing the implicated drug or agent is the first step in managing liver toxicity. The researchers note that in most cases of liver toxicity, people recover immediately without further treatment after stopping the exposure.

• #38 Toxic Hepatitis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/toxic-hepatitis

  The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation. However, they are considered candidates for transplantation only if they have been completely abstinent from alcohol and in a treatment program for a minimum of six months.

• #39 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #40 Hepatitis: What It Is, Symptoms, Transmission & Treatments

  https://my.clevelandclinic.org/health/diseases/hepatitis

  Hepatitis happens when something causes inflammation in your liver. Treatment includes lifestyle changes, medication and a liver transplant. […] Toxic hepatitis can be acute or chronic. […] In general, treatments include: Lifestyle changes. Changes like avoiding alcohol, eating a variety of fruits and vegetables and getting extra rest help with the symptoms of hepatitis A and acute hepatitis B. Antivirals. This is treatment for chronic hepatitis B. Antivirals cant cure it. But taking them reduces the risk that youll spread hepatitis B to someone else and decreases the chances of causing complications. Youll need to take these medications for the rest of your life. Direct-acting antivirals (DDA). These drugs can cure hepatitis C. They target proteins that viruses use to infect cells in your body. Liver transplant. You may need a liver transplant if chronic hepatitis B leads to liver failure.

• #41 Toxic Hepatitis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/toxic-hepatitis

  The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation. However, they are considered candidates for transplantation only if they have been completely abstinent from alcohol and in a treatment program for a minimum of six months.

• #42 Toxic Hepatitis | UCSF Department of Surgery

  https://hpbsurgery.ucsf.edu/condition/toxic-hepatitis

  The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] In the case of alcohol-related liver damage, joining a program such as Alcoholics Anonymous and/or enrolling in a treatment/rehabilitation program is highly recommended and may be required. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation. However, they are considered candidates for transplantation only if they have been completely abstinent from alcohol and in a treatment program for a minimum of six months.

• #43 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Management of protracted drug-induced cholestasis is similar to that for primary biliary cirrhosis. […] Cholestyramine may be used for alleviation of pruritus. […] Ursodeoxycholic acid may be used. […] Lastly, consulting a hepatologist is also helpful. […] No specific antidote is available for the vast majority of hepatotoxic agents. […] Emergency liver transplantation has utility in the setting of drug-induced fulminant hepatic injury. […] Considering early liver transplantation is important. […] The Model for End-Stage Liver Disease score can be used to evaluate short-term survival in an adult with end-stage liver disease. […] This can help stratify candidates for liver transplantation. […] Another criterion commonly used for liver transplantation is the Kings College criteria.

• #44 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Kings College criteria for liver transplantation in cases of acetaminophen toxicity are as follows: pH less than 7.3 (irrespective of grade of encephalopathy), Prothrombin time (PT) greater than 100 seconds or international normalized ratio greater than 7.7, Serum creatinine level greater than 3.4 mg/dL in patients with grade III or IV encephalopathy. […] Measurement of lactate levels at 4 and 12 hours also helps in early identification of patients who require liver transplantation. […] Kings College criteria for liver transplantation in other cases of drug-induced liver failure are as follows: PT greater than 100 seconds (irrespective of grade of encephalopathy) or Any three of the following criteria: (1) Age younger than 10 years or older than 40 years; (2) etiology of non-A/non-B hepatitis, halothane hepatitis, or idiosyncratic drug reactions; (3) duration of jaundice of more than 7 days before onset of encephalopathy; (4) PT greater than 50 seconds; (5) serum bilirubin level greater than 17 mg/dL. […] The prognosis is highly variable depending on the patient’s presentation and stage of liver damage.

• #45

  https://www.painscale.com/article/conventional-medical-treatments-for-toxic-hepatitis

  Toxic hepatitis is caused by drugs, alcohol, or exposure to certain chemicals. […] The first step in treating toxic hepatitis is identifying the cause and stopping exposure to the substance causing the condition. In addition to stopping exposure, other conventional treatments for toxic hepatitis include supportive care, medications, or a liver transplant. […] In many cases of toxic hepatitis, once exposure to the substance has stopped, supportive care rest, hydration, and the avoidance of substances (e.g., alcohol, acetaminophen, etc.) that may damage the liver is the only treatment required. […] If toxic hepatitis is caused by an overdose of acetaminophen, the oral form of the medication acetylcysteine can help limit liver damage caused by the overdose. […] Severe liver damage due to toxic hepatitis can lead to liver failure. In this case, a liver transplant may be necessary. […] The liver is often able to heal itself, so early elimination of exposure to the substance that caused toxic hepatitis is usually enough to relieve symptoms and prevent further complications.

• #46 Drug induced liver injury (DILI) – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/dili/

  Your liver has an amazing ability to repair itself and so most people with drug induced liver injury will make a complete recovery. […] The main thing that will help you to get better is time. […] Eating a healthy balanced diet, taking exercise, and avoiding smoking and alcohol will all help your liver to work well. […] Always talk to your doctor before trying alternative or complementary medicines, even if they are natural or have been recommended by a practitioner.

• #47 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  Modify Your Diet: A. Decrease the amount of fatty foods and cholesterol that you eat. Extra fat stored in the liver can cause a liver to begin scarring sooner. B. Increase the amount of actual water that you drink during a 24 hour day. Water helps flush the chemicals and poisons out of your body. To find out how much water you should drink in a 24 hour period: take your body weight in pounds and divide it by 2. This equals how many ounces of water you should drink each day. […] Light Daily Exercise: Light daily exercise such as walking will help boost your immune system as well as help decrease excess fat stored in your liver. Talk to your provider about what the best form of exercise would be for you. […] Symptoms That Need to be Reported to Your Provider: A. White or Gray colored stools B. Coca-Cola colored urine C. Increased amount of time before a cut or wound stops bleeding D. The white part of your eyes turning yellow.

• #48 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  Modify Your Diet: A. Decrease the amount of fatty foods and cholesterol that you eat. Extra fat stored in the liver can cause a liver to begin scarring sooner. B. Increase the amount of actual water that you drink during a 24 hour day. Water helps flush the chemicals and poisons out of your body. To find out how much water you should drink in a 24 hour period: take your body weight in pounds and divide it by 2. This equals how many ounces of water you should drink each day. […] Light Daily Exercise: Light daily exercise such as walking will help boost your immune system as well as help decrease excess fat stored in your liver. Talk to your provider about what the best form of exercise would be for you. […] Symptoms That Need to be Reported to Your Provider: A. White or Gray colored stools B. Coca-Cola colored urine C. Increased amount of time before a cut or wound stops bleeding D. The white part of your eyes turning yellow.

• #49 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  Modify Your Diet: A. Decrease the amount of fatty foods and cholesterol that you eat. Extra fat stored in the liver can cause a liver to begin scarring sooner. B. Increase the amount of actual water that you drink during a 24 hour day. Water helps flush the chemicals and poisons out of your body. To find out how much water you should drink in a 24 hour period: take your body weight in pounds and divide it by 2. This equals how many ounces of water you should drink each day. […] Light Daily Exercise: Light daily exercise such as walking will help boost your immune system as well as help decrease excess fat stored in your liver. Talk to your provider about what the best form of exercise would be for you. […] Symptoms That Need to be Reported to Your Provider: A. White or Gray colored stools B. Coca-Cola colored urine C. Increased amount of time before a cut or wound stops bleeding D. The white part of your eyes turning yellow.

• #50 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  If you dont have access to treatment right now, if youve gone through the treatment and werent able to clear the virus or if youre infected with another virus such as HIV that can be harmful to the liver, there are several things you can do to help keep your liver healthier. […] Get your Hepatitis A and Hepatitis B vaccinations: Youve got one viral infection your liver has to deal with. Prevent other viral infections that are known to harm the liver and are vaccine preventable. […] Eliminate Harmful Chemicals From Your Body: A. ALL alcohol, in any amount, is harmful to your liver. Eliminate all alcohols from your diet. B. ALL illicit drugs are harmful to your liver. Studies have shown that the use of marijuana can cause the liver to progress to scarring sooner. It doesnt make any difference on how the drug is used (injecting, smoking, eating, inhaling), they are all harmful to your liver. Eliminate all illegal drug use. Talk with your provider or a counselor to identify ways to help you stop the use of any illegal drugs. C. Decrease polluted air that you breathe, such as: 1) Second-hand cigarette smoke 2) Car exhaust 3) Agricultural pesticides 4) Smog

• #51 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  If you dont have access to treatment right now, if youve gone through the treatment and werent able to clear the virus or if youre infected with another virus such as HIV that can be harmful to the liver, there are several things you can do to help keep your liver healthier. […] Get your Hepatitis A and Hepatitis B vaccinations: Youve got one viral infection your liver has to deal with. Prevent other viral infections that are known to harm the liver and are vaccine preventable. […] Eliminate Harmful Chemicals From Your Body: A. ALL alcohol, in any amount, is harmful to your liver. Eliminate all alcohols from your diet. B. ALL illicit drugs are harmful to your liver. Studies have shown that the use of marijuana can cause the liver to progress to scarring sooner. It doesnt make any difference on how the drug is used (injecting, smoking, eating, inhaling), they are all harmful to your liver. Eliminate all illegal drug use. Talk with your provider or a counselor to identify ways to help you stop the use of any illegal drugs. C. Decrease polluted air that you breathe, such as: 1) Second-hand cigarette smoke 2) Car exhaust 3) Agricultural pesticides 4) Smog

• #52 Drug-induced Hepatitis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/drug-induced-hepatitis

  Drug-induced hepatitis treatment and management: There is no specific treatment for drug-induced hepatitis other than discontinuing the medication that is causing the problem. […] People with acute hepatitis should avoid physical exertion, alcohol, paracetamol and any other hepatotoxic substances. […] Unfortunately, other than the use of N-acetylcysteine for paracetamol hepatotoxicity, there are no specific antidotes for drug-induced liver disease. […] Supportive care for acute liver failure and even liver transplantation may be required.

• #53 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  Get a Prescription Review: Have your doctor or pharmacist review all your prescribed medications to ensure that none of your medications are toxic for your liver. Ask your provider about alternatives to any medications that may harm your liver. […] Use Over The Counter Medications Properly: Always follow the directions on the package, unless told otherwise by your medical provider. […] Be Careful With Vitamins, Herbs and Mineral Use: A. Some of the Fat Soluble vitamins can build up in your system and be toxic to your liver. Check with your provider before taking more than the daily recommendations. B. Before taking any herbal supplement, research it and make sure that it doesnt have the potential to damage to your liver, such as Kava, Valerian Root and Sassafras. Check with your doctor before adding any herbal supplements to your diet. C. The liver has to store all the excess iron that you take in during a day. Its important not to eat more iron in a 24 hour day than what your body actually uses. Extra iron stored in the liver can cause your liver to begin scarring sooner. Talk with a dietician or your doctor to find out how much iron you should eat in a day.

• #54 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis treatment depends on the extent of damage to your liver, but you may be able to help your liver heal and/or protect the health of your liver by making lifestyle changes. […] Toxic hepatitis treatment depends on the extent of damage to your liver. After checking your liver, your healthcare provider may recommend that you: Avoid taking certain medications or supplements that may cause liver toxicity. Stop drinking alcohol. Talk to your supervisor about changing duties if you’re exposed to chemicals in your workplace. Wear protective equipment if you work with certain chemicals. […] In many instances, toxic hepatitis is curable. Your liver can replace damaged cells over time, reversing the damage that occurred. But if you have advanced liver disease like cirrhosis, you may be at risk for liver failure. Your care team may talk to you about liver transplantation.

• #55 Antiretroviral Associated Adverse Effects and Management Recommendations for Hepatic Events | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/pediatric-arv/hepatic-events-full

  Most ARV drugs have been associated with hepatitis, but a strong association exists between hepatitis and the use of NVP and EFV. […] NVP, EFV, ABC, RAL, DTG, and MVC have been associated with hepatitis in the context of HSRs. […] Acute toxic hepatitis occurs most commonly within the first few months of therapy, but it can occur later. […] Hepatitis can be a manifestation of IRIS if it occurs early in therapy, especially in patients with HBV or HCV coinfection. […] For NVP-Associated Hepatic Events in Adults, female sex with pre-NVP CD4 count 250 cells/mm3 and male sex with pre-NVP CD4 count 400 cells/mm3 are risk factors. […] Avoid concomitant use of hepatotoxic medications. […] In patients with elevated levels of hepatic enzymes (5 times to 10 times ULN) or chronic liver disease, most clinicians would avoid NVP.

• #56 Antiretroviral Associated Adverse Effects and Management Recommendations for Hepatic Events | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/pediatric-arv/hepatic-events-full

  Obtain AST and ALT levels at baseline and at least every 3-4 months thereafter; monitor at-risk patients more frequently. […] If a patient experiences hepatitis that is attributed to NVP, NVP should be discontinued permanently. […] Discontinue all ARV drugs and other potentially hepatotoxic drugs.

• #57 Living with Hepatitis: How to Stay Healthy | doh

  https://dchealth.dc.gov/service/living-hepatitis-how-stay-healthy

  Modify Your Diet: A. Decrease the amount of fatty foods and cholesterol that you eat. Extra fat stored in the liver can cause a liver to begin scarring sooner. B. Increase the amount of actual water that you drink during a 24 hour day. Water helps flush the chemicals and poisons out of your body. To find out how much water you should drink in a 24 hour period: take your body weight in pounds and divide it by 2. This equals how many ounces of water you should drink each day. […] Light Daily Exercise: Light daily exercise such as walking will help boost your immune system as well as help decrease excess fat stored in your liver. Talk to your provider about what the best form of exercise would be for you. […] Symptoms That Need to be Reported to Your Provider: A. White or Gray colored stools B. Coca-Cola colored urine C. Increased amount of time before a cut or wound stops bleeding D. The white part of your eyes turning yellow.

• #58 Treatment of toxic hepatitis in COVID-19 patients – Maev – Terapevticheskii arkhiv

  https://ter-arkhiv.ru/0040-3660/article/view/121853

  The aim of the present study is to increase the effectiveness of the treatment of toxic hepatitis in patients who have undergone COVID-19. […] The use of drugs with hepatoprotective effect in the form of monotherapy in groups 1 (UDCA) and 2 (ademethionine) showed a low therapeutic effect with positive dynamics of clinical and laboratory indicators of toxic hepatitis activity. The use of combined treatment in group 3 (UDCA and ademethionine) demonstrated the maximum therapeutic effect, pronounced positive dynamics in the form of normalization of clinical and laboratory indicators of toxic hepatitis activity.

• #59 Hepatitis & Hepatotoxicity Management | OPDIVO® (nivolumab)

  https://www.opdivohcp.com/dosing/treatment-modifications/hepatic

  Withhold treatment if ALT or AST is 3x ULN but 10x ULN with concurrent total bilirubin 2x ULN until adverse reactions recover to Grades 0-1. […] Permanently discontinue treatment if ALT or AST is 10x ULN or 3x ULN with concurrent total bilirubin 2x ULN. […] Consider corticosteroid therapy for hepatic adverse reactions if OPDIVO + CABOMETYX or OPDIVO Qvantig + CABOMETYX is withheld or discontinued. […] Administer 1 to 2 mg/kg/day prednisone or equivalent until improvement to Grade 1 or less. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. […] Consider administration of other systemic immunosuppressants in patients whose immune-mediated adverse reactions are not controlled with corticosteroid therapy.

• #60 Hepatotoxicity | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/TUB/english/Hepatotoxicity

  All TB drugs may cause hepatotoxicity. However, certain drugs are likely more responsible than others for this adverse effect. […] Clinical hepatitis can be fatal and action should be taken immediately. […] Patient with symptoms of hepatitis: Stop all TB drugs and perform LFTs: a) AST or ALT or bilirubin 3 times upper limit of normal (ULN): wait for resolution of symptoms, perform LFTs weekly and restart TB treatment when LFTs are 3 times ULN. […] If LFTs continue to increase after stopping TB treatment, then ongoing progressive drug-induced hepatitis or an unrelated cause of hepatitis should be suspected. […] In most cases, the same treatment can be resumed without incident. The objective is to resume the initial regimen or an alternative regimen as rapidly as possible. […] If symptoms reappear or LFTs re-increase, try to reintroduce the TB drugs one by one.

• #61 Hepatotoxicity | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/TUB/english/Hepatotoxicity

  The alternative regimen depends on the drug causing hepatotoxicity: Z is involved: 2(HR)E/7(HR), H is involved: 6RZE-Lfx, R is involved: treat as MDR/RR-TB. […] When restarting TB treatment, start with the drugs least hepatotoxic (E, Lfx or Mfx, Cs or Trd, Dlm, Am or S, Ipm/Cln or Mpm), then drugs moderately hepatotoxic (Bdq, Cfz, Amx/Clav), then give the most hepatotoxic (Z, H, R, Eto or Pto, PAS).

• #62 Hepatotoxicity | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/TUB/english/Hepatotoxicity

  The alternative regimen depends on the drug causing hepatotoxicity: Z is involved: 2(HR)E/7(HR), H is involved: 6RZE-Lfx, R is involved: treat as MDR/RR-TB. […] When restarting TB treatment, start with the drugs least hepatotoxic (E, Lfx or Mfx, Cs or Trd, Dlm, Am or S, Ipm/Cln or Mpm), then drugs moderately hepatotoxic (Bdq, Cfz, Amx/Clav), then give the most hepatotoxic (Z, H, R, Eto or Pto, PAS).

• #63 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis recovery time depends on: How long you’ve had the condition. The damage to your liver. If damage is mild to moderate, your liver may take a few weeks or months to replace the damaged cells and heal. […] Talk to your healthcare provider about the causes of liver toxicity and how you can improve your liver’s health. If you have severe liver damage from toxic hepatitis, your healthcare provider can talk with you about treatment options to restore your health.

• #64 Toxic Hepatitis | Health & Human Services

  https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/toxic-hepatitis

  Diagnosis of toxic hepatitis caused by chemical exposure requires a thorough assessment of the patient, including clinical signs and symptoms, laboratory testing, an exposure history, and possible liver imaging and biopsy. […] If a person is suspected of having, or has been diagnosed with toxic hepatitis, exposure to the chemical or drug(s) identified as the possible causative agent should be immediately discontinued. Rest is indicated if symptoms are severe. If nausea and vomiting are significant, hospitalization and intravenous fluids may be advised. People with acute hepatitis should avoid physical exertion, alcohol, and any hepatotoxic substances. Consultation with a medical toxicologist should be considered. […] Liver inflammation usually subsides within days or weeks after exposure to the chemical or drug is stopped. In severe cases, liver failure can occur. The overall mortality rate for drug-induced liver injury is around 5 percent.

• #65 Treatment for liver toxicity: Options and recovery

  https://www.medicalnewstoday.com/articles/liver-toxicity-treatment

  The aims of liver toxicity treatment are to manage the symptoms, regenerate damaged liver cells, and prevent further damage. Options include medication, supportive therapy, emergency care, liver transplant, and stopping exposure to the toxin. […] Depending on the cause and severity, medical treatment can sometimes reverse the damage to the liver that has occurred. A persons symptoms may also improve once exposure to the toxin has stopped. […] A person with permanent liver damage will require a liver transplant to restore liver function. Although treatment can sometimes reverse acute liver failure, a liver transplant may also be the only cure in many instances. […] According to a study in the Journal of Hepatology, discontinuing the implicated drug or agent is the first step in managing liver toxicity. The researchers note that in most cases of liver toxicity, people recover immediately without further treatment after stopping the exposure.

• #66 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis recovery time depends on: How long you’ve had the condition. The damage to your liver. If damage is mild to moderate, your liver may take a few weeks or months to replace the damaged cells and heal. […] Talk to your healthcare provider about the causes of liver toxicity and how you can improve your liver’s health. If you have severe liver damage from toxic hepatitis, your healthcare provider can talk with you about treatment options to restore your health.

• #67 Liver Damage From Medication—Early Signs and Drug Types

  https://www.verywellhealth.com/drug-induced-liver-disease-1943023

  If your liver has been damaged by a drug, the first step is for you to stop taking it, if possible. […] Depending on your symptoms and the severity of the damage to your liver, your provider may also want you to rest, avoid exercise, and get fluids through a vein (IV). […] Most cases of drug-induced liver injury will start to get better within days to weeks of stopping the medication. […] It usually takes two to three months to make a full recovery. During this time, you may get supportive care to address your symptoms. […] Managing the condition for the long term means you’ll have to avoid anything that could harm the liver, such as using alcohol or taking acetaminophen.

• #68 Hepatotoxicity – Wikipedia

  https://en.wikipedia.org/wiki/Hepatotoxicity

  In most cases, liver function will return to normal if the offending drug is stopped early. Additionally, the patient may require supportive treatment. In acetaminophen toxicity, however, the initial insult can be fatal. Fulminant hepatic failure from drug-induced hepatotoxicity may require liver transplantation. In the past, glucocorticoids in allergic features and ursodeoxycholic acid in cholestatic cases had been used, but there is no good evidence to support their effectiveness. […] An elevation in serum bilirubin level of more than 2 times ULN with associated transaminase rise is an ominous sign. This indicates severe hepatotoxicity and is likely to lead to mortality in 10% to 15% of patients, especially if the offending drug is not stopped (Hy’s Law). […] The following therapeutic drugs were withdrawn from the market primarily because of hepatotoxicity: Troglitazone, bromfenac, trovafloxacin, ebrotidine, nimesulide, nefazodone, ximelagatran and pemoline.

• #69 Toxic Hepatitis | Health & Human Services

  https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/toxic-hepatitis

  Diagnosis of toxic hepatitis caused by chemical exposure requires a thorough assessment of the patient, including clinical signs and symptoms, laboratory testing, an exposure history, and possible liver imaging and biopsy. […] If a person is suspected of having, or has been diagnosed with toxic hepatitis, exposure to the chemical or drug(s) identified as the possible causative agent should be immediately discontinued. Rest is indicated if symptoms are severe. If nausea and vomiting are significant, hospitalization and intravenous fluids may be advised. People with acute hepatitis should avoid physical exertion, alcohol, and any hepatotoxic substances. Consultation with a medical toxicologist should be considered. […] Liver inflammation usually subsides within days or weeks after exposure to the chemical or drug is stopped. In severe cases, liver failure can occur. The overall mortality rate for drug-induced liver injury is around 5 percent.

• #70 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Early recognition of drug-induced liver reactions is essential to minimizing injury. […] Monitoring hepatic enzyme levels is appropriate and necessary with a number of agents, especially with those that lead to overt injury. […] For drugs that produce liver injury unpredictably, biochemical monitoring is less useful. […] ALT values are more specific than AST values. […] ALT values that are within the reference range at baseline and rise 2- to 3-fold should lead to enhanced vigilance in terms of more frequent monitoring. […] ALT values 4-5 times higher than the reference range should lead to prompt discontinuation of the drug. […] The general recommendations for evaluating and monitoring potential drug-induced hepatotoxicity may not be suitable for all situations and should be modified for special populations, such as people with preexisting liver disease or malignancies, and in light of accumulating data.

• #71 An Update on Treatment of Drug-Induced Liver Injury

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4521262/

  Drug-induced liver injury (DILI) has been linked to more than 1,000 medications and remains the most common cause of acute liver failure in the United States. Here, we review the most current literature regarding treatment and make recommendations for the management of this relatively common disease. Since treatment of DILI remains largely elusive, recent studies have attempted to define new management strategies for these difficult patients. Early diagnosis and withdrawal of the suspected medication is the mainstay of treatment of DILI. […] For acetaminophen and Amanita mushroom poisoning, there are specific therapies in use. Finally, there are other possible management modalities for DILI, including corticosteroids and ursodeoxycholic acid. […] Once a specific drug has been identified as the cause of DILI, it must be discontinued. Following withdrawal of the suspected agent, therapy is largely supportive with a few notable exceptions for acetaminophen and Amanita mushroom poisoning.

• #72 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  Drug-induced hepatotoxicity is an acute or chronic liver injury secondary to drugs or herbal compounds. The principle treatment is the removal of the offending agent and close observation for resolution. […] Treatment begins with the removal of the offending agent, and the prognosis for recovery is usually favorable after discontinuation of the drug. […] The principal treatment for drug-induced hepatotoxicity is the removal of the offending agent. N-acetyl-cysteine (NAC) is the treatment for intrinsic DILI secondary to acetaminophen toxicity, as this promotes the regeneration of glutathione, leading to the detoxification of the toxic metabolite. The other specific therapy that is available is L-carnitine for valproic acid overdose. Glucocorticoid therapy is usually used when the histological appearance of DILI resembles that of autoimmune hepatitis. For this reason, it has a limited role and usually does not change the course of recovery. Symptomatic therapies such as bile acid sequestrants for cholestatic DILI or antihistamines for pruritis can be used with some efficacy. Hospital admission is required for patients with signs or symptoms of DILI progression or ALF. If ALF is suspected, early liver transplant consideration is essential because there is high mortality with ALF. An important additional aspect of management is reporting cases of DILI to regulatory bodies to evaluate if the suspected drug needs to be withdrawn from the market.

• #73 Treatment for liver toxicity: Options and recovery

  https://www.medicalnewstoday.com/articles/liver-toxicity-treatment

  Depending on the type of drug that is causing liver toxicity, the doctor may administer an antidote to counter the effect of DILI and prevent liver damage. […] Doctors may recommend supportive therapy to treat severe symptoms of liver toxicity. […] A liver transplant may be the only option for people who have severely impaired liver function and have not responded to other forms of medical therapy. […] Stopping exposure to the toxic agent is the first line of treatment for liver toxicity. Other forms of treatment include medications, supportive therapy, and emergency care. In rare cases, a liver transplant may be necessary. Treatment aims to reverse liver damage while restoring liver function, and it generally leads to favorable outcomes.

• #74 An Update on Treatment of Drug-Induced Liver Injury

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4521262/

  Drug-induced liver injury (DILI) has been linked to more than 1,000 medications and remains the most common cause of acute liver failure in the United States. Here, we review the most current literature regarding treatment and make recommendations for the management of this relatively common disease. Since treatment of DILI remains largely elusive, recent studies have attempted to define new management strategies for these difficult patients. Early diagnosis and withdrawal of the suspected medication is the mainstay of treatment of DILI. […] For acetaminophen and Amanita mushroom poisoning, there are specific therapies in use. Finally, there are other possible management modalities for DILI, including corticosteroids and ursodeoxycholic acid. […] Once a specific drug has been identified as the cause of DILI, it must be discontinued. Following withdrawal of the suspected agent, therapy is largely supportive with a few notable exceptions for acetaminophen and Amanita mushroom poisoning.

• #75 Treatment for liver toxicity: Options and recovery

  https://www.medicalnewstoday.com/articles/liver-toxicity-treatment

  Depending on the type of drug that is causing liver toxicity, the doctor may administer an antidote to counter the effect of DILI and prevent liver damage. […] Doctors may recommend supportive therapy to treat severe symptoms of liver toxicity. […] A liver transplant may be the only option for people who have severely impaired liver function and have not responded to other forms of medical therapy. […] Stopping exposure to the toxic agent is the first line of treatment for liver toxicity. Other forms of treatment include medications, supportive therapy, and emergency care. In rare cases, a liver transplant may be necessary. Treatment aims to reverse liver damage while restoring liver function, and it generally leads to favorable outcomes.

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