Çocuk Sağlığı ve Hastalıkları Dergisi 2004 , Vol 47 , Num 3
Drug-associated hepatotoxicity new advances in pathogenesis and clinical findings
Makbule Eren1, İnci Nur Saltık-Temizel2, Nurten Koçak3
Hacettepe Üniversitesi Tıp Fakültesi 1Pediatri Uzmanı, 2Pediatrik Gastroenteroloji Uzmanı, 3Emekli Pediatri Profesörü Drug-induced hepatic injury is often an unrecognized entity, it is the most frequent reason cited for the withdrawal from the market of an approved drug. The liver is essential for the metabolism of drugs and various agents. Most drugs are lipophilic, enabling them to cross the membranes of intestinal cells. They gain a hydrophilic structure through steps of biotransformation by cytochrome P-450 enzyme system in the liver. This process yields water soluble products and these are easily secreted in the urine or bile. Being the center of biotransformation, the liver is also the target organ for drug toxicity. Due to genetic polymorphism of the enzyme system, age, gender differences, infections, coexisting liver pathology and coadministered agents, different individuals exhibit different reactions to the same drug even in the same pharmacological doses. Here we review the type of drug reactions, their clinical outcomes, diagnostic and therapeutic modalities and pathogenesis of drug-induced liver injury. Anahtar Kelimeler : hepatotoksisite, izoniazid, asetaminofen, sitokrom P-450, ilaç reaksiyonu, hepatotoxicity, isoniazid, acetaminophen, cytochrome P-450, drug reaction
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