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Hepatotoxicity of Cardiovascular Drugs

  • Chapter
Book cover Drug-Induced Hepatotoxicity

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 121))

Abstract

Society often pays a price for the progress achieved in the therapeutic benefits offered by new drugs, namely, an increased incidence of toxic side effects. Fortunately, the benefits of advanced therapy outweigh the risks posed by these side effects. The introduction of a new drug can be followed by various types of unexpected reactions, including hepatotoxicity. It is often difficult to establish an association between a drug and reported liver injury, but it becomes certain when the same liver impairment recurs after repeated administration of the same drug (ELKINGTON et al. 1969; ELIASTAM and HOLMES 1971). Infrequently, the response pattern can be so characteristic as to be diagnostic of toxicity of a specific drug, such as phospholipidosis or alcoholic-like hepatitis in response to coralgil or amiodarone (DE LA IGLESIA et al. 1974; POUCELL et al. 1984; GUIGUI et al. 1988). Impairment of hepatic function is associated with the intake of many drugs (ZIMMERMAN 1990). including several cardiovascular drugs that are the main focus of this chapter. In some cases the mechanism of hepatic injury has been recognized; in others, the side effect profile has not been clearly established. These side effects by drugs may complicate patient treatment and, in particular, restrict the use of drugs that are essential to patient management such as antiarrythmics, antihypertensives. or hypolipidemics. If the drug causing the hepatic toxicity is the only effective agent to control a life-threatening situation. hepatic side effects can be acceptable until pharmacologic control is established. An example is the management of intractable cardiac arrhythmias requiring amiodarone. Hepatic reactions have been attributed to many cardiovascular drugs and will be discussed in detail below.

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  1. R. G. Cameron
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  2. F. A. de la Iglesia
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  3. G. Feuer
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Editors and Affiliations

  1. Department of Pathology Division of Experimental Pathology, University of Toronto, Medical Sciences Building, 1 King’s College Circle, M5S 1A8, Toronto, Ontario, Canada

    Ross G. Cameron M.D., Ph.D.

  2. Department of Clinical Biochemistry Banting Institute, University of Toronto, Room 521, 100 College Street, M5G 1L5, Toronto, Ontario, Canada

    George Feuer Ph.D.

  3. Parke-Davis Pharmaceutical Research Division Department of Pathology and Experimental Toxicology, Warner Lambert Company, 2800 Plymouth Road, 48105, Ann Arbor, MI, USA

    Felix A. de la Iglesia M.D.

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Cameron, R.G., de la Iglesia, F.A., Feuer, G. (1996). Hepatotoxicity of Cardiovascular Drugs. In: Cameron, R.G., Feuer, G., de la Iglesia, F.A. (eds) Drug-Induced Hepatotoxicity. Handbook of Experimental Pharmacology, vol 121. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-61013-4_21

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