Nonsteroid Drug-Induced Cholestasis and Experimental Cholestasis
While chemically induced hepatotoxic reactions appeared in the medical literature of the early 1900’s, it can be said that the problem of drug-induced cholestasis is a relatively recent occurrence. Its emergence as a distinct clinical problem arises from the time of the introduction of chlorpromazine as a therapeutic agent. Since this time, a number of other nonsteroid drugs have been shown to possess this property (Table I). It can be seen that while certain classes of pharmacologic agents have been associated with this adverse response, chemical similarities between all of the substances are really lacking. In addition to the drugs listed in Table I, certain steroids have been associated with cholestatic reactions in man; among these drugs one finds several anabolic steroids and the oral contraceptives. While the production of liver injury in man by drugs or other chemicals is not a new phenomenon, one can say that the cholestatic reactions produced by these drugs were largely unexpected and unpredictable from their known effects in laboratory animals.
KeywordsAnabolic Steroid Bile Flow Microsomal Enzyme Intrahepatic Cholestasis Toxic Hepatitis
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