Medicinal (medical) hepatitis is a liver injury that occurs due to the toxic effect of medicinal products on liver cells with the development of inflammation in them, and even necrosis.
One of the most important functions of the liver is the neutralization and neutralization of toxic substances entering the body and entering the liver with a flow of blood.
Due to the presence of a number of enzymatic systems in it there is a transformation of these substances (including medicinal) into harmless, with their subsequent excretion from the body. This process undergoes several stages, during which intermediate substances - metabolites are formed, still have a pronounced toxic effect.
However, with prolonged intake of drugs, as well as their very high dosage, depletion of neutralizing enzyme systems may occur, so the metabolites begin to damage the liver tissue -
Develops medical hepatitis.
The development of medical hepatitis is possible when using the following groups of drugs:
- Nonsteroidal anti-inflammatory drugs;
- Anti-TB drugs;
- Hormonal drugs, including contraceptives, steroidal sex hormones, corticosteroids;
- Anticonvulsants, antiepileptic drugs;
- Antibiotics and sulfanilamides;
- Antiarrhythmic drugs.
The main manifestations of medical hepatitis
As a rule, in this type of hepatitis there are the same symptoms as in other types of toxic hepatitis. Therefore, the importance of determining the cause of the disease has a biochemical analysis of blood, as well as punctual analysis (detailed history collection) of the occurrence of liver symptoms - the reaction of the body to one or another medicine and its abolition.
If the re-appointment of these drugs worsens the state of health of the patient - with a high probability, it can be assumed that the drug and became the cause of the development of medicinal hepatitis.
Particular attention is paid to such factors as the presence of other members of the family intolerance to this drug (hereditary predisposition to certain biochemical reactions in the body), the presence of allergies and/or diseases of the immune system, digestive system, etc., the presence of others Toxic effects on the body (use of alcohol, other drugs, occupational hazards, etc.).
In particularly severe cases, acute necrosis of the liver develops with the development of complications, early onset of liver failure and even hepatic coma with fatal outcome.
If two or more drugs with hepatotoxicity are used, changes in the liver develop even with a small dosage and in a shorter time.
The timely withdrawal of a toxic drug and the conduct of regenerative therapy usually leads to a complete recovery of the patient.
Research in medicinal hepatitis
- General analysis of blood and urine;
- Biochemical blood test with the definition of bilirubin and its fractions, ALT and AST, protein fractions;
- Research of the system of coagulation of blood (coagulogram);
- Ultrasound of the abdominal cavity organs.
Basic principles of treating hepatitis
- It is urgent to cancel the medicine causing hepatitis. In this case, the doctor chooses a replacement for him. It is strictly forbidden to choose the medicine for a patient independently.
- Removal from the body of the remains of the hepatotoxic drug - detoxification therapy, in severe cases, it is permissible to conduct hemodialysis.
- Recovery of the liver with hepatoprotectors (drugs that improve the metabolism in the liver cells and contribute to their recovery).
- Symptomatic therapy and diet №5 for Pevsner (fractional nutrition, restriction of fats, but sufficient content in food of carbohydrates, proteins, vitamins; prohibited greasy, fried and spicy foods, alcohol).