Hoy revisamos los principales medicamentos que pueden llevar a una hepatitis o incluso cirrosis, entre los que encontramos el paracetamol, el metotrexate, el halotano, alopurinol, amoxicilina entre otros.
Of course, as in other videos about medicines that cause some adverse event, they shouldn’t be prescribed or taken in any situation. of course, the whole list of medicines in the video description, i’ll leave a website it’s important to mention that this is a liver with cirrhosis. however, some of these may cause acute or severe liver damage again, when they’re used with
Care and proper monitoring, the risk is low. and it’s so big because it carries out a large number of functions that is, it’s in charge of the production and storage of glucose, and in coagulation, where it produces many of the clotting proteins, it’s important to mention that practically every medicine will are completely harmless, disappear, and the patient is healthy,
Now, you might remember that we already have a video i’m not going to elaborate so much on what the liver does when we take a drug, there’s something called phase 1 metabolism. or transforming it to, sooner or later, remove that drug. if too much oxygen or reactive oxygen species are produced, the cytochrome and polar metabolites make medicines more water soluble, in
Phase 2, where some drugs enter directly and others enter through phase 1, we take compounds that the liver can handle very well and are very safe, again, here we have a bunch of substances that it will add to these medicines. however, in phase 2, we can also find the production of toxic substances of course, i’m not going to make an extensive list. so i’m only going to
Focus on the ones that frequently first of all, we have paracetamol, which is probably the most famous of course, we’ll also have some medicines for gout. this means medicines against fungus and bacteria and also antivirals, we’ve already seen these in previous videos. i’ll leave the link up here. we have things like allopurinol, which is, again, for gout. there, we have
Many drugs for different indications also, some antiarrhythmics may cause hepatic toxicity. which is the classic example of drugs that may cause hepatic toxicity, this is important because paracetamol is used by almost the entire population, we’re going to have that paracetamol is the most important of these drugs. again, most of our patients usually don’t present damage
To their liver. who are combining these drugs that we’re seeing now very often, people tell me that paracetamol isn’t an anti-inflammatory. now, antimicrobials, we already stated that there’s a huge number, because they say, “i’m taking medicine, can i drink alcohol?” that many antibiotics and antimicrobials will also cause liver damage. among the antibiotics, there’s
Amoxicillin with or without clavulanate. we can see that we have a large number of antibiotics such as gastrointestinal or urinary tract infections. we have ketoconazole and fluconazole, the most important ones. and again, in some patients, this liver damage can be quite severe. they should be carefully prescribed to patients with liver damage, et cetera. among the
Classic examples, we have methotrexate or methotrexato, again, all of these are used for autoimmune diseases. but we already had the slide full of antimicrobials. so it’s very important to keep it in mind when it comes to liver damage. and anabolic steroids, which are used for muscle mass gain. we need to keep checking the liver of these patients in the nervous system,
Also combined with statins, which is probably one of the most frequently associated with liver damage. which we also already saw in a previous video, and i’ll leave the link up here. more aggressive or strict monitoring of the livers of our patients even though basically all of the statins may of course, we’d need to avoid giving these drugs unless the patient already comes
With the diagnosis. again, especially in the beginning, also, they won’t always have cirrhosis. they may only have liver fibrosis this topic about hepatic steatosis and fat in the liver, we have several non-invasive indicators, such as the fibro index, all of these use different parameters, such as to determine whether my patient is at risk of having liver fibrosis or not,
A fatty liver or nonalcoholic hepatic steatosis as well as liver fibrosis, that’s a very specialized study that our patients would have to undergo. they’d also need to get the elastography and these scores checked periodically. if we can find an option that isn’t harmful to the liver, it’s better to give that option to our patient as long as it’s appropriate. we need to
Pay close attention to the well-being of that patient’s liver. for example, very often, we prescribe paracetamol without prior study. also, if they’re prescribed chronically, from liver enzymes to, again, these other important studies i wouldn’t like to leave without first thanking some of the people i’d like to dedicate this video to malinche carrasco, daniela valencia,
Gustavo francioli, enrique segarra, rosaura murillo, aurora martínez, moni lagos-leigh, yami pascacio, and antonio guizar. you’ll find a link to a repository or website i recommend you to also give that other website a look that was all for today’s video. i hope you liked and understood it. share the information.