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Drug induce hepatotoxicity

Liver and Drug induced hepato toxicity (Ref. Hari. 18th ed., Pg - 2562)
Cholestatic Reactions
Non Inflammatory (Bland) Inflammatory
Bland cholestasis is characterized by cholestasis in the absence of inflammation (hepatitis)
This is believed to result from inhibition of various hepatobiliary transport systems.
Important drugs causes bland cholestasis
1. Estrogen and OCP
2. Anabolic steroids
3. Indinavir
4. Mercaptopurine
5. Cyclosporine
Inflammatory cholestasis is charachterized by inflammation of portal tracts with bile duct injury often associated with allergic features like eosinophilia
Important drugs causing inflammatory cholestasis
1. Azathioprine
2. Azithromycin
3. Chlorothiazide
4. Penicillamine
5. Semisynthetic penicillins

Examples of Common Causes of Drug-Induced Hepatotoxicity
  Pattern Drug
1. Cholestasis Chlorpromazine, High-dose oestrogens
2. Cholestatic hepatitis NSAIDs, Statins
3. Acute hepatitis Rifampicin, Isoniazid, Pyrazinamide
4. Non-alcoholic steatohepatitis Amiodarone
5. Venous outflow obstruction Busulfan, Azathioprine
6. Fibrosis Methotrexate
7. Granulomatous hepatitis Phenyl Butazone, allopurinol, INH, carbamazepine

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