Hepatotoxicity Among Poisoned Patients: A Cross-sectional Study
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 12 No. 4 (2022),
16 October 2022
,
Page 38931
https://doi.org/10.32598/ijmtfm.v12i4.38931
Abstract
Background: Drug-induced liver injury is a major cause of hepatitis worldwide. In patients diagnosed with acute poisoning, drug-induced liver injury is a critical challenge. This study aims to evaluate the pattern of hepatotoxicity in poisoned patients admitted to Loghman Hakim Hospital.
Methods: In this cross-sectional study that was conducted at Loghman Hakim hospital, the clinical records of poisoned patients were evaluated and patients with hepatotoxicity were selected for final analysis. The clinical and para-clinical information of these patients was recorded. The SPSS software, version 23. was used for statistical analysis.
Results: A total of 260 cases were included in this study. The Mean±SD age of patients was 38.24±16.29 years and most of them were male (79.2%). Patients with narcotics poisoning had the highest prevalence (38.5%), especially when they were taken together with acetaminophen or benzodiazepine. In addition, among the patients studied, those with underlying cardiovascular disease are more likely to develop hepatotoxicity.
Conclusion: In conclusion, among people with various types of poisoning, it seems that narcotics (opium, heroin, methadone, etc.), particularly when taken together with acetaminophen or benzodiazepines, cause hepatotoxicity and increase serum levels of liver aminotransferases. Also, in the study population, patients with underlying cardiovascular disease had a higher chance of liver injury. Therefore, clinicians are recommended to accurately monitor the sign and symptoms of hepatotoxicity in these populations.
- Drug-induced hepatotoxicity
- Poisoning
- Overdose
- Liver
How to Cite
References
Szántová M, Sedlačko J, Jakabovičová M. [Drug and herbal hepatotoxicity: An overview of clinical classifications (Czech)]. Vnitřní lékařství. 2018; 64(4):384-93. [DOI:10.36290/vnl.2018.057] [PMID]
Amadi CN, Orisakwe OE. Herb-induced liver injuries in developing nations: An update. Toxics. 2018; 6(2):24. [DOI:10.3390/toxics6020024] [PMID] [PMCID]
Lucena MI, Molokhia M, Shen Y, Urban TJ, Aithal GP, Andrade RJ, et al. Susceptibility to amoxicillin-clavulanate-induced liver injury is influenced by multiple HLA class i and ii alleles. Gastroenterology. 2011; 141(1):338-47. [DOI:10.1053/j.gastro.2011.04.001] [PMID] [PMCID]
Hoofnagle JH, Björnsson ES. Drug-induced liver injury-types and phenotypes. The New England Journal of Medicine. 2019; 381(3):264-73. [DOI:10.1056/NEJMra1816149] [PMID]
Roy DN, Goswami R. Drugs of abuse and addiction: A slippery slope toward liver injury. Chemico-Biological Interactions. 2016; 255:92-105. [DOI:10.1016/j.cbi.2015.09.018] [PMID]
Lancaster EM, Hiatt JR, Zarrinpar A. Acetaminophen hepatotoxicity: An updated review. Archives of Toxicology. 2015; 89(2):193-9. [DOI:10.1007/s00204-014-1432-2] [PMID]
No author. Livertox: Clinical and research information on drug-induced liver injury. Bethesda: National Institute of Diabetes and Digestive and Kidney Diseases; 2012. [PMID]
Smith HS. Opioid metabolism. Mayo Clinic Proceedings; 2009; 84(7):613-24. [DOI:10.1016/S0025-6196(11)60750-7] [PMID] [PMCID]
Lurie E, Soloviova A, Alyabieva T, Kaplun A, Panchenko L, Shvets V. Effect of novel aromatic derivative of GABA on lipid peroxidation in chronically morphinized rats. Biochemistry and Molecular Biology International. 1995; 36(1):13-9. [PMID]
Masini A, Gallesi D, Giovannini F, Trenti T, Ceccarelli D. Membrane potential of hepatic mitochondria after acute cocaine administration in rats-the role of mitochondrial reduced glutathione. Hepatology. 1997; 25(2):385-90. [DOI:10.1053/jhep.1997.v25.pm0009021951] [PMID]
Tang B, Zhang Y, Liang R, Yuan P, Du J, Wang H, et al. Activation of the δ-opioid receptor inhibits serum deprivation-induced apoptosis of human liver cells via the activation of PKC and the mitochondrial pathway. International Journal of Molecular Medicine. 2011; 28(6):1077-85. [DOI:10.3892/ijmm.2011.784]
Atici S, Cinel I, Cinel L, Doruk N, Eskandari G, Oral U. Liver and kidney toxicity in chronic use of opioids: An experimental long term treatment model. Journal of Biosciences. 2005; 30(2):245-52. [DOI:10.1007/BF02703705] [PMID]
Nagamatsu K, Ohno Y, Ikebuchi H, Takahashi A, Terao T, Takanaka A. Morphine metabolism in isolated rat hepatocytes and its implications for hepatotoxicity. Biochemical Pharmacology. 1986; 35(20):3543-8. [DOI:10.1016/0006-2952(86)90624-6]
Panchenko L, Pirozhkov S, Nadezhdin A, VIu B, Usmanova N. [Lipid peroxidation, peroxyl radical-scavenging system of plasma and liver and heart pathology in adolescence heroin users (Russian)]. Voprosy Meditsinskoi Khimii. 1999; 45(6):501-6. [PMID]
Verna EC, Schluger A, Brown RS. Opioid epidemic and liver disease. JHEP Reports. 2019; 1(3):240-55. [DOI:10.1016/j.jhepr.2019.06.006] [PMID] [PMCID]
Greenfield SF, Back SE, Lawson K, Brady KT. Substance abuse in women. Psychiatric Clinics of North America. 2010; 33(2):339-55. [DOI:10.1016/j.psc.2010.01.004] [PMID] [PMCID]
Møller S, Bernardi M. Interactions of the heart and the liver. European Heart Journal. 2013; 34(36):2804-11. [DOI:10.1093/eurheartj/eht246] [PMID]
Rawal H, Patel BM. Opioids in cardiovascular disease: Therapeutic options. Journal of Cardiovascular Pharmacology and Therapeutics. 2018; 23(4):279-91. [DOI:10.1177/1074248418757009] [PMID]
- Abstract Viewed: 490 times
- pdf Downloaded: 399 times