Liver damage caused by drugs and toxins

1. Big picture

Drug- and toxin-induced liver injury means liver damage caused by prescription drugs, over-the-counter drugs, herbal products, supplements, recreational drugs, industrial toxins, or natural toxins such as poisonous mushrooms.

For the exam, think in 3 steps:

1. Recognize the liver injury pattern: hepatocellular, cholestatic, mixed, fatty liver, vascular injury, chronic fibrosis/cirrhosis.
2. Identify the dangerous cause: especially paracetamol/acetaminophen overdose, Amanita phalloides mushroom poisoning, antituberculosis drugs, antiepileptics, herbal/bodybuilding supplements.
3. Treat immediately: stop the drug, stabilize acute liver failure, give