Drug induced liver injury: what is the clinical pharmacist role?
Keywords:lesão hepática induzida por medicamentos; farmácia clínica; reconciliação medicamentosa, farmacêutico.
AbstractObejctives: Describe the drug induced liver injury, the mainly groups of drugs related, their clinical manifestation and discuss the clinical pharmacist role to the detection and management these injury. T
Methods: This is a literature research conducted through a narrative review on drug induced liver injury and the clinical pharmacist role in the detection and management of it.
Results: antibiotics, non-steroidal anti-inflammatory and anticonvulsants drugs are the main agents associated with liver injury. The toxicity may occur by direct reaction (between 24 and 48 hours after drug administration) or idiosyncratic reactions (between five and 90 days after drug administration). The clinical ranges from slight changes in liver enzymes to fulminant hepatic failure, which can progress to death. The treatment is essentially supported, however, the suspension of the drug is the first step to prevent or minimize injury.
Considerations: The detection of drug-induced liver injury depends on the establishment of the causation and the exclusion of other causes such as hepatitis B or C. The pharmacist can contribute to the early detection of drug-induced liver injury by medication reconciliation at admission, evaluation of prescription and monitoring of laboratory tests.
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