Do you want to take some medicine to relieve your illness? Keep this list and don’t take it randomly!

Nowadays, everyone is always accompanied by various drugs

Many people's first reaction when they are sick is

Take some medicine to "press it down"

If you can’t hold it down, increase the amount and frequency

Even if you are not sick

Don't take some medicine or health products

I always feel insecure.

But the old saying goes

All medicines are poisonous, so don’t take them randomly!

If you "eat wrong"

May cause liver damage

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In the past decade or so, the incidence of drug-induced liver injury has increased significantly and has become one of the common causes of liver disease in China.

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Drug-induced liver injury, also known as drug-induced liver disease, generally refers to liver damage induced by taking various prescription drugs, health products, traditional Chinese medicine, etc. It is a common adverse drug reaction.

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This drug-induced liver damage may further develop into cirrhosis , and in severe cases may lead to acute liver failure or even death !

There are currently more than a thousand drugs that can be clearly linked to drug-induced liver injury.

Common drugs that cause drug-induced liver injury include:

Traditional Chinese medicine: Polygonum multiflorum, Psoralea corylifolia, Dioscorea bulbifera, Bupleurum chinense, Tripterygium wilfordii, Notoginseng, Coriolus mulberry leaf, etc.

Dietary supplements: vitamin A, retinoic acid (isotretinoin, acitretin), retinoids, etc.;

Cardiovascular system drugs: fenofibrate, atorvastatin, captopril, propranolol, mexiletine, amiodarone, etc.;

Nonsteroidal anti-inflammatory drugs: ibuprofen, acetaminophen (paracetamol), aspirin, etc.;

Anti-tuberculosis drugs: rifampicin, isoniazid, pyrazinamide, etc.;

Antibiotics: penicillin, cephalosporin, tetracycline, sulfonamides, etc.;

Anti-tumor drugs: cytarabine, methotrexate, thalidomide, tamoxifen, taxanes, lomustine, etc.

Note! It does not mean that taking the above drugs will definitely lead to drug-induced liver injury . Its pathogenesis is usually related to the drug dosage .

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Generally speaking, as long as you follow your doctor's instructions and take your medication, the risk of drug-induced liver injury is relatively low.

However, if you feel that taking one vitamin pill a day is not enough and you insist on taking 8 pills, a healthy person may end up suffering from drug-induced liver damage.

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Of course, there are special cases. Some people with special constitutions may suffer from severe drug-induced liver damage no matter how much of a certain drug they take. This requires us to identify some symptoms in time to see if drug-induced liver damage has occurred.

If you are taking the above-mentioned drugs and have no underlying liver disease, but have the following symptoms, be careful of the possibility of drug-induced liver injury!

● Nausea, bloating, and loss of appetite;

● The skin and eyes turn yellow, and the whole body turns into a "Minion";

● Fever, weakness, itchy skin and rash;

● Light or clay-colored stools;

● Severe drug-induced liver injury can also cause mental symptoms such as drowsiness, temperament changes, and impaired consciousness.

If you experience any of the above symptoms, it is recommended that you seek medical attention immediately!

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If you suspect that a drug is the cause, you should stop taking the drug under the advice of a professional doctor . Usually, the symptoms will be relieved after stopping the drug.

For certain drugs that carry a high risk of side effects after discontinuation, if you cannot stop taking them immediately, please consult your doctor to consider changing medications, or use liver-protecting drugs at the same time to reduce the burden on the liver.

Elderly people who have multiple chronic diseases and take multiple therapeutic drugs often need to take medication for life. In addition, the poor metabolic function of the elderly affects the metabolism of drugs in the body, and the risk of drug-induced liver injury also increases .

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In addition, people with a history of drug allergies, liver and kidney dysfunction, long-term alcohol consumption, nutritional disorders, and newborns are at greater risk of drug-induced liver injury than ordinary people .

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This group of people should be more careful when taking medicine, follow the doctor's advice, use the medicine reasonably, and prevent drug-induced liver injury.

1. Do not take medicine randomly: take medicine according to the course and dosage prescribed by the doctor, and do not believe in folk remedies with unclear sources, unknown ingredients, and uncertain efficacy; eliminate irrational use of medicines. Taking several medicines together may not cure the disease quickly, and due to the interaction between drugs, it may also cause more serious liver damage.

2. Take medications strictly as directed by the doctor: For patients with a history of drug-induced liver damage in their family or who have experienced liver damage themselves, if they must take certain medications with potential liver-damaging effects, they must take medications strictly as directed by the doctor.

3. Regularly monitor liver function: Patients who take hepatotoxic drugs for a long time should remember to monitor liver function regularly.

4. Do not take health supplements at will: Do not think that dietary supplements and health supplements are all good without any harm. The drugs mentioned above have potential liver damage and should be used with caution, especially for middle-aged and elderly people. Do not take health supplements at will;

Statement: This article is a medical-related educational popular science article. It does not involve specific treatment methods or medical behaviors and cannot replace hospital visits.

Author

Zhong Shitong, Class of 2020, Five-year Clinical Medicine Program, West China School of Clinical Medicine

Xiao Weirui, 2020, five-year clinical medicine student at West China School of Clinical Medicine

Yu Zihuan, Class of 2020, Five-Year Clinical Medicine Program, West China School of Clinical Medicine

Liang Meiting, Class of 2020, Five-year Clinical Medicine Program, West China School of Clinical Medicine

Chen Shiqi, Class of 2020, Five-Year Clinical Medicine Program, West China School of Clinical Medicine

Zhang Yuyang, Class of 2020, Five-year Clinical Medicine Program, West China School of Clinical Medicine

Experts who reviewed this article

References

1. Drug-Induced Liver Injury Prevention and Treatment Technical Committee of China Pharmaceutical Biotechnology Association, Drug-Induced Liver Disease Group of Chinese Society of Hepatology. Chinese Guidelines for the Diagnosis and Treatment of Drug-Induced Liver Injury (2023 Edition)[J]. Chinese Journal of Hepatology, 2023, 31(4): 355-384.

2. Chinese Medical Association, Chinese Medical Association Journal, Chinese Society of Gastroenterology, et al. Primary diagnosis and treatment guidelines for drug-induced liver injury (2019)[J]. Chinese Journal of General Practitioners, 2020,19(10):868-875.

3. Ge Junbo, Xu Yongjian, Wang Chen, et al. Internal Medicine (9th Edition)[M]. People's Medical Publishing House, 2018:401-404.

4. Fontana RJ. Pathogenesis of idiosyncratic drug-induced liver injury and clinical perspectives. Gastroenterology. 2014;146(4):914-928.

5. Xie Xinhe, Zhao Ruiling. Research progress in clinical diagnosis of drug-induced liver injury[J]. Medical Review, 2019,25(20):4044-4048+4054.

6. European Association for the Study of the Liver. Clinical Practice Guideline Panel: Chair:; Panel members; EASL Governing Board representative:. EASL Clinical Practice Guidelines: Drug-induced liver injury. J Hepatol. 2019;70(6):1222-1261.

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