Acute and chronic hepatitis
Certain drugs can cause acute and chronic hepatitis (inflammation of liver cells) that can lead to necrosis (death) of the cells. Acute drug-induced hepatitis is defined as hepatitis that lasts less than 3 months, while chronic hepatitis lasts longer than 3 months. Acute drug-induced hepatitis is much more common than chronic drug-induced hepatitis by a ratio of 9:1.
Typical symptoms of drug-induced hepatitis include:
loss of appetite,
nausea,
vomiting,
fever,
weakness,
tiredness, and
abdominal pain.
In more serious cases, patients can develop dark urine, fever, light-colored stool, and jaundice (a yellow appearance to the skin and white portion of the eyes). Patients with hepatitis usually have high blood levels of AST, ALT, and bilirubin. Both acute and chronic hepatitis typically resolve after stopping the drug, but sometimes acute hepatitis can be severe enough to cause acute liver failure (see discussion later in this article), and chronic hepatitis can on rare occasions, lead to permanent liver damage and cirrhosis.
Examples of drugs that can cause acute hepatitis include acetaminophen (Tylenol), phenytoin (Dilantin), aspirin, isoniazid (Nydrazid, Laniazid), diclofenac (Voltaren), and amoxicillin/clavulanic acid (Augmentin).
Examples of drugs that can cause chronic hepatitis include minocycline (Minocin), nitrofurantoin (Furadantin, Macrodantin), phenytoin (Dilantin), propylthiouracil, fenofibrate (Tricor), and methamphetamine ("ecstasy")..
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