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Hepatotoxic Medication

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1. Hepatotoxic Medication

Hepatotoxic Medication Hepatotoxic Medication Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hepatotoxic Medication Hepatotoxic (...) Medication Aka: Hepatotoxic Medication , Hepatotoxic Supplement , Hepatotoxin From Related Chapters II. Causes: Medications associated with Cirrhosis Alpha- (no longer available in United States) III. Causes: Most common drug causes of Acute Hepatitis -Clavulanic Acid ( , most common cause) (AST often rises above 5000, most common cause of in U.S.) Anti- medications Trimethoprim-sulfamethoxazole (mimics ) (mimics ) IV. Causes: Hepatotoxic Medications (including mild transaminase elevations) s s Avoid

2018 FP Notebook

2. Acetaminophen Hepatotoxicity. (PubMed)

Acetaminophen Hepatotoxicity. Acetaminophen (APAP) is one of the most popular and safe pain medications worldwide. However, due to its wide availability, it is frequently implicated in intentional or unintentional overdoses where it can cause severe liver injury and even acute liver failure (ALF). In fact, APAP toxicity is responsible for 46% of all ALF cases in the United States. Early mechanistic studies in mice demonstrated the formation of a reactive metabolite, which is responsible (...) death and the resulting inflammatory response. Furthermore, it discusses the translation of these findings to humans and the emergence of new therapeutic interventions.Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

2019 Seminars in Liver Disease

3. Is Intravenous Acetylcysteine More Effective Than Oral Administration For the Prevention of Hepatotoxicity in Acetaminophen Overdose?

Is Intravenous Acetylcysteine More Effective Than Oral Administration For the Prevention of Hepatotoxicity in Acetaminophen Overdose? Systematic Review Snapshot TAKE-HOME MESSAGE Rates of hepatotoxicity from acetaminophen appear to be similar whether acetylcysteine is administered orally or intravenously. Is Intravenous Acetylcysteine More Effective Than Oral Administration for the Prevention of Hepatotoxicity in Acetaminophen Overdose? EBEM Commentators Evan Schwarz, MD Brian Cohn, MD (...) Washington University School of Medicine St. Louis, MO Results Pooled rates of hepatotoxicity with intravenous versus oral acetylcysteine. Time of administration Intravenous Acetylcysteine (95% CI), % Oral Acetylcysteine (95% CI), % Overall 13.2 (8.7–19.6) 12.6 (8.2–18.8) Early 5.3 (3.2–8.5) 5.9 (4.2–8.1) Late 23.3 (11.7–41.1) 26.3 (23.6–29.0) CI, Con?dence interval. Head-to-head randomized trials com- paring the ef?cacy of intravenous versus oral acetylcysteine were not identi?ed by the investigators

2013 Annals of Emergency Medicine Systematic Review Snapshots

4. Risk factors for erlotinib-induced hepatotoxicity: a retrospective follow-up study. (PubMed)

Risk factors for erlotinib-induced hepatotoxicity: a retrospective follow-up study. Erlotinib is a drug used for the treatment of non-small cell lung cancer (NSCLC) and pancreatic cancer. Severe hepatotoxicity was observed in 4% to 31% of patients receiving erlotinib treatment prompting delay or termination of treatment. Only a few factors related to hepatotoxicity of erlotinib have been reported. No study has investigated the role of concomitant medications and erlotinib-induced hepatotoxicity (...) . The aim of this study was to investigate the association between erlotinib-induced hepatotoxicity and various factors including concomitant medications in patients with NSCLC and pancreatic cancer.From January 2014 to June 2017, a retrospective study was conducted in patients with NSCLC and pancreatic cancer, who were treated with erlotinib. Various data were reviewed, including sex, age, body weight, height, body surface area (BSA), underlying disease, Eastern Cooperative Oncology Group (ECOG

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2018 BMC Cancer

5. Hepatotoxicity of Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review of Randomized Controlled Trials. (PubMed)

Hepatotoxicity of Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review of Randomized Controlled Trials. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used medication in several countries, including Thailand. NSAIDs have been associated with hepatic side effects; however, the frequency of these side effects is uncertain.To systematically review published literature on randomized, controlled trials that assessed the risk of clinically significant hepatotoxicity associated (...) with NSAIDs.Searches of bibliographic databases EMBASE, PubMed, and the Cochrane Library were conducted up to July 30, 2016, to identify randomized controlled trials of ibuprofen, naproxen, diclofenac, piroxicam, meloxicam, mefenamic acid, indomethacin, celecoxib, and etoricoxib in adults with any disease that provide information on hepatotoxicity outcomes.Among the 698 studies, 18 studies met the selection criteria. However, only 8 studies regarding three NSAIDs (celecoxib, etoricoxib, and diclofenac

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2018 International journal of hepatology

6. Hepatotoxicity in hyperthyroid patient after consecutive methimazole and propylthiouracil therapies (PubMed)

Hepatotoxicity in hyperthyroid patient after consecutive methimazole and propylthiouracil therapies Methimazole (MMI) and propylthiouracil (PTU) are widely used antithyroid drugs (ATD) that have been approved for the treatment of hyperthyroidism. Hepatotoxicity may be induced by these drugs, though they exert dissimilar incidence rates of hepatotoxicity and, possibly, with different underlying pathogenic mechanisms. We report the case of a 55-year-old woman with no relevant medical history

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2018 Endocrinology, diabetes & metabolism case reports

7. A Suspected Case of Hydralazine-Induced Hepatotoxicity: A Case Report and Review of Literature (PubMed)

, which all resolved after discontinuation of hydralazine, and liver function test results also dramatically improved. CONCLUSIONS It is imperative that clinicians be aware of the possible hepatotoxicity of hydralazine and its clinical features so that the medication can be promptly discontinued to help promote liver recovery. This case report will add to the current literature about such infrequent cases of hydralazine-induced hepatotoxicity. (...) A Suspected Case of Hydralazine-Induced Hepatotoxicity: A Case Report and Review of Literature BACKGROUND Hydralazine is an effective antihypertensive agent but may rarely have devastating hepatotoxic effects that are extremely variable, thus making the diagnosis difficult. CASE REPORT We report the case of a 74-year-old male patient who had transaminitis after being started on hydralazine by his cardiologist for poorly controlled hypertension. He had extreme dizziness, nausea, and weakness

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2018 The American journal of case reports

8. Retrospective cohort study comparing the risk of severe hepatotoxicity in hospitalized patients treated with echinocandins for invasive candidiasis in the presence of confounding by indication. (PubMed)

Retrospective cohort study comparing the risk of severe hepatotoxicity in hospitalized patients treated with echinocandins for invasive candidiasis in the presence of confounding by indication. To compare the risk of severe hepatotoxicity with anidulafungin versus caspofungin and micafungin in hospitalized adults.This retrospective cohort study combined data from two large US- based hospital electronic medical record databases. Severe hepatotoxicity was a Grade ≥ 3 liver function test (LFT (...) or comorbidities were: critical care admissions: 75.3% versus 52.6 and 48.6%; and organ failures: 69.4% versus 46.7 and 51.5%. Adjusted IRRs of severe hepatotoxicity for anidulafungin versus caspofungin and micafungin were 1.43 (p = 0.002) and 1.19 (p = 0.183) overall, and 0.88 (P = 0.773) and 0.97 (P = 0.945) for normal baseline LFT, respectively.Accounting for confounders, severe hepatotoxicity risk was not significantly different across echinocandins in this real-world head-to-head study. Anidulafungin

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2018 BMC Infectious Diseases

9. Hold the Gaba: A Case of Gabapentin-induced Hepatotoxicity (PubMed)

Hold the Gaba: A Case of Gabapentin-induced Hepatotoxicity A drug-induced liver injury is one of the most common causes of acute liver failure. While acetaminophen is the most common etiology, other offending medications include amoxicillin-clavulanic acid, amiodarone, isoniazid, and fluoroquinolones to name a few. Gabapentin, a gamma-aminobutyric acid (GABA) analogue, has infrequently been reported to cause liver injury; however, the causality in the previous reports is contested. Herein, we

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2018 Cureus

10. Variants p.Q1236H and p.E1143G in mitochondrial DNA polymerase gamma POLG1 are not associated with increased risk for valproate-induced hepatotoxicity or pancreatic toxicity: A retrospective cohort study of patients with epilepsy. (PubMed)

other pathogenic mutations in POLG1 and determined the occurrence of VPA-induced hepatotoxicity (VHT) or pancreatic toxicity in a cohort of patients with epilepsy.Patients with epilepsy (N = 367) were retrospectively identified from medical record files and screened for mutations in POLG1. Patients who had received VPA monotherapy and carried either of the two variants, p.Q1236H or p.E1143G, without other pathogenic mutations in POLG1 (n = 33, variant group) and patients without these variants (n (...) Variants p.Q1236H and p.E1143G in mitochondrial DNA polymerase gamma POLG1 are not associated with increased risk for valproate-induced hepatotoxicity or pancreatic toxicity: A retrospective cohort study of patients with epilepsy. Previous studies have suggested that heterozygous variants p.Q1236H and p.E1143G in mitochondrial DNA polymerase gamma (POLG1) increase the risk for liver injury for patients on valproate (VPA) therapy. We assessed the prevalence of these common variants and seven

2018 Epilepsia

11. Multiple Perspectives of Qingkailing Injection-Fraction-Single Compound in Revealing the Hepatotoxicity of Baicalin and Hyodeoxycholic Acid. (PubMed)

Multiple Perspectives of Qingkailing Injection-Fraction-Single Compound in Revealing the Hepatotoxicity of Baicalin and Hyodeoxycholic Acid. The complexity of ingredients in traditional Chinese medical formulas and the limited consideration of toxicological responses are fundamental issues that hamper prognostic information of drug quality control.A multidisciplinary approach for quality control of Qingkailing injection (QKL) regarding drug induced liver toxicity was described for the first (...) and glutathione (GSH) depletion. In parallel, hyodeoxycholic acid from F4 induced cell loss, nucleus condense, and GSH reduction as well.Our work provides multiple perspectives based on injection-fractions-single compound format to improve QKL pharmacovigilance through revealing the potential hepatotoxic material basis. Additionally, our study provides an integrating paradigm for the comprehensive and systematic quality control of traditional Chinese medical formulas.Copyright © 2017 Elsevier B.V. All rights

2017 Journal of Ethnopharmacology

12. Hepatotoxicity following systemic therapy for colorectal liver metastases and the impact of chemotherapy-associated liver injury on outcomes after curative liver resection. (PubMed)

Hepatotoxicity following systemic therapy for colorectal liver metastases and the impact of chemotherapy-associated liver injury on outcomes after curative liver resection. Patients with colorectal liver metastases (CLM) have remarkably benefited from the advances in medical multimodal treatment and surgical techniques over the last two decades leading to significant improvements in long-term survival. More patients are currently undergoing liver resection following neoadjuvant chemotherapy

2017 European Journal of Surgical Oncology

13. Multicentre study of posaconazole delayed-release tablet serum level and association with hepatotoxicity and QTc prolongation. (PubMed)

November 2013 and 14 November 2014. Patients were included if they received posaconazole DRT with a posaconazole level obtained between days 5 and 14. Clinical data, including demographics, hepatotoxic medications, posaconazole levels, LFTs and QTc intervals, were obtained. Association of factors with changes in LFTs and QTc prolongation was assessed using linear and logistic regression.One hundred and sixty-six study patients were included. The median posaconazole level was 1250 (range 110-4220) ng/mL (...) additional hepatotoxic medication, there was a mean change in TBILI of 0.13 mg/dL ( P  =   0.02) and ALK of 7.1 U/L ( P  =   0.09). No statistically significant association between posaconazole level and QTc interval prolongation was found.We did not identify an association between posaconazole serum concentrations and LFT elevations or QTc prolongation. However, some LFTs were found to increase with more hepatotoxic medications administered.© The Author 2017. Published by Oxford University Press

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2017 Journal of Antimicrobial Chemotherapy

14. Ciprofloxacin-induced Hepatotoxicity in a Healthy Young Adult (PubMed)

-induced hepatitis. In this case report, we describe a young 29-year-old female with a previous medical history significant for pyelonephritis and ovarian cyst who presented to the emergency room with signs and symptoms suggestive of progressive liver injury for two weeks that started two days after a complete course of ciprofloxacin therapy for a UTI. An extensive workup failed to identify a particular cause for the hepatotoxicity. The associated onset of symptoms following ciprofloxacin use (...) Ciprofloxacin-induced Hepatotoxicity in a Healthy Young Adult Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic that is widely used in the treatment of many common infections, including urinary tract infections (UTIs). Despite the increase in Escherichia coli resistance to ciprofloxacin, especially in the United States (US), clinicians continue to utilize the high bioavailability of this drug in urine to counter UTIs. A rare adverse effect following use of ciprofloxacin is drug

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2017 Cureus

15. Pilot Algorithm Designed to Help Early Detection of HMG-CoA Reductase Inhibitor-Induced Hepatotoxicity (PubMed)

Pilot Algorithm Designed to Help Early Detection of HMG-CoA Reductase Inhibitor-Induced Hepatotoxicity To enable early detection of adverse drug reactions (ADRs) in patients using HMG-CoA reductase inhibitors (statins), we developed an algorithm that automatically detects liver injury caused by statins from Electronic Medical Record (EMR) data. We verified the performance of our algorithm through manual ADR assessment and a direct chart review.The subjects in this study were patients who had

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2017 Healthcare informatics research

16. Increased hepatotoxicity among HIV-infected adults co-infected with Schistosoma mansoni in Tanzania: A cross-sectional study (PubMed)

and after controlling for other factors associated with hepatotoxicity including hepatitis B or C and anti-tuberculosis medication use (adjusted odds ratio = 3.0 [1.6-5.8], p = 0.001).Our work demonstrates a strong association between S. mansoni infection and hepatotoxicity among HIV-infected patients on antiretroviral therapy. Our study highlights the importance of schistosome screening and treatment for patients starting antiretroviral therapy in schistosome-endemic settings. Additional studies (...) Increased hepatotoxicity among HIV-infected adults co-infected with Schistosoma mansoni in Tanzania: A cross-sectional study Little is known about hepatotoxicity in patients with schistosome and HIV co-infections. Several studies have reported increased liver enzymes and bilirubin levels associated with schistosome infection. We investigated whether HIV-infected adults on antiretroviral therapy who had S. mansoni co-infection had a higher prevalence of hepatotoxicity than those without.We

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2017 PLoS neglected tropical diseases

17. Hepatotoxicity with Vismodegib: An MD Anderson Cancer Center and Research on Adverse Drug Events and Reports Project (PubMed)

within 4 years of FDA approval. Vismodegib should be used in patients with severe liver disease only after careful consideration, and concomitant hepatotoxic medications should be avoided. Rapid dissemination of such safety concerns is expected to result in fewer serious hepatotoxic AEs and more optimal outcomes for patients with cancer receiving vismodegib. (...) Hepatotoxicity with Vismodegib: An MD Anderson Cancer Center and Research on Adverse Drug Events and Reports Project On 30 January 2012, the US FDA approved vismodegib (Erivedge®, Genentech, CA, USA) for the management of both metastatic and locally advanced basal cell carcinoma.Our objective was to identify evidence of hepatotoxicity with vismodegib in the FDA Adverse Event Reporting System (FAERS) in treated patients in two National Cancer Institute Comprehensive Cancer Centers.FAERS

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2017 Drugs in R&D

19. Ciprofloxacin Exposure Leading to Fatal Hepatotoxicity: An Unusual Correlation (PubMed)

Ciprofloxacin Exposure Leading to Fatal Hepatotoxicity: An Unusual Correlation BACKGROUND Ciprofloxacin is a commonly used fluoroquinolone antibiotic. It is occasionally associated with benign elevations in liver enzymes. Few reports in the literature correlate ciprofloxacin with significant liver injury. We present a fatal case of ciprofloxacin-induced liver failure. CASE REPORT  A 74-year-old female was successfully treated with ciprofloxacin for a urinary tract infection (UTI (...) unremarkable. Liver biopsy showed cholestatic hepatitis of unclear etiology. The patient was discharged again following a mild decline in liver enzymes. Soon after, the patient was admitted to our institution with similar complaints. Serum transaminases remained elevated, with an increase in alkaline phosphatase and bilirubin. The Council for International Organizations of Medical Sciences/the Roussel Uclaf Causality Assessment Method (CIOMS/RUCAM) scale was found to be 8, outlining a high or definite

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2016 The American journal of case reports

20. Unexpected paracetamol (acetaminophen) hepatotoxicity at standard dosage in two older patients: time to rethink 1 g four times daily? (PubMed)

Unexpected paracetamol (acetaminophen) hepatotoxicity at standard dosage in two older patients: time to rethink 1 g four times daily? We present two cases of acute hepatotoxicity associated with elevated paracetamol (acetaminophen) levels in older patients. Both patients were receiving a standard European dose of oral paracetamol (2 × 500 mg QDS) with no risk factors for slowed metabolism (weight <50 kg, interacting medications, hepatic enzyme inducers, history of liver disease). Significantly (...) , both patients had recently had a dose escalation from 'as needed' dosing to 4 g daily, and the medication was being administered by nursing staff. Our experience shows that even when prescribed appropriately at the usual therapeutic dosage, paracetamol can be hepatotoxic.© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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2016 Age and ageing

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