Drug-induced liver injury (DILI) accounts for about 50% of acute liver failure cases in the United States. Diagnosis is challenging, especially due to the myriad combinations of potentially hepatotoxic medications and clinical presentations. Unexplained liver injury should prompt a thorough investigation of medication administration (e.g., for accidental or intentional overdose) and the use of herbal and dietary supplements. The framework for approaching DILI includes the following: (1) categorize the injury as either intrinsic or idiosyncratic, (2) establish time course and pattern of injury, and (3) triage effectively to minimize mortality risk.
KeywordsDrug-induced liver injury Medications Hepatotoxicity Abnormal liver enzymes Acetaminophen Hy’s law
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