Drug Induced Liver Disorder

Abstract

One of the most difficult adverse medication reactions seen in clinical practice is drug-induced liver injury (DILI), which is a significant contributor to liver-related morbidity. It happens when drugs, nutritional supplements, herbal products, or hazardous substances cause liver damage via immune-mediated or direct cellular toxicity. The clinical range of DILI includes acute liver failure necessitating liver transplantation as well as modest, asymptomatic increase of liver enzymes. The prevalence of DILI is rising worldwide because to the growing use of prescription pharmaceuticals, over-the-counter treatments, and herbal supplements. Numerous processes, including as oxidative stress, mitochondrial dysfunction, immunological activation, apoptosis, and altered bile acid transport, are involved in the pathophysiology of DILI. Susceptibility is influenced by both host-related and drug-related factors, including age, sex, alcohol intake, and genetic polymorphisms. Among the most commonly implicated compounds include antibiotics, antitubercular agents, nonsteroidal anti-inflammatory drugs, antiepileptic pharmaceuticals, and herbal treatments. Fatigue, nausea, jaundice, pruritus, stomach discomfort, and hepatic encephalopathy are among the many possible clinical symptoms. The diagnosis is primarily dependent on clinical history, test results, exclusion of alternate etiologies, and causality evaluation techniques because there is no particular diagnostic biomarker. The cornerstone of management continues to be the prompt identification and cessation of the offending substance. Reducing the frequency and severity of DILI requires increased knowledge, cautious monitoring, pharmacovigilance, and sensible prescribing practices.