P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH
Introduction and Aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially he...
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Elsevier
2021-09-01
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Series: | Annals of Hepatology |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268121000764 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rodrigo Dorelo Samantha T.A. Barcelos Magela Barros Valeria Elustondo Ysela Y.P. Pérez Martin Oricchio Nelson D.S. Uribe Nelia Hernandez Dvora Joveleviths Mário R. Álvares-da-Silva |
spellingShingle |
Rodrigo Dorelo Samantha T.A. Barcelos Magela Barros Valeria Elustondo Ysela Y.P. Pérez Martin Oricchio Nelson D.S. Uribe Nelia Hernandez Dvora Joveleviths Mário R. Álvares-da-Silva P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH Annals of Hepatology Liver diseases drug-induced liver injury acute-on-chronic liver failure acute liver failure |
author_facet |
Rodrigo Dorelo Samantha T.A. Barcelos Magela Barros Valeria Elustondo Ysela Y.P. Pérez Martin Oricchio Nelson D.S. Uribe Nelia Hernandez Dvora Joveleviths Mário R. Álvares-da-Silva |
author_sort |
Rodrigo Dorelo |
title |
P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH |
title_short |
P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH |
title_full |
P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH |
title_fullStr |
P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH |
title_full_unstemmed |
P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH |
title_sort |
p-11 potentially hepatotoxic drugs are still being prescribed to liver disease patients under tertiary care: it is time to say enough |
publisher |
Elsevier |
series |
Annals of Hepatology |
issn |
1665-2681 |
publishDate |
2021-09-01 |
description |
Introduction and Aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital. Materials and Method: Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure. Results: From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death. Conclusion: PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk. Conflict of interest statement: The authors have nothing to disclose. |
topic |
Liver diseases drug-induced liver injury acute-on-chronic liver failure acute liver failure |
url |
http://www.sciencedirect.com/science/article/pii/S1665268121000764 |
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doaj-f4db1a2afb6346b0a618d70053d0c1be2021-09-29T04:23:27ZengElsevierAnnals of Hepatology1665-26812021-09-0124100377P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGHRodrigo Dorelo0Samantha T.A. Barcelos1Magela Barros2Valeria Elustondo3Ysela Y.P. Pérez4Martin Oricchio5Nelson D.S. Uribe6Nelia Hernandez7Dvora Joveleviths8Mário R. Álvares-da-Silva9Department of Gastroenterology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, Brazil; Address for correspondence Serviço de Gastroenterologia do Hospital de Clínicas de Porto Alegre. Rua Ramiro Barcelos, n° 2350/ sala 2033, 2° andar. CEP 90035-903, Bairro Santana, Porto Alegre, Rio Grande do Sul (RS) – Brazil. Corresponding author, Rodrigo Dorelo, MD, Assistant Professor, Department of Gastroenterology, Hospital de Clínicas, Av. Italia S/n CP, 11600, Montevideo, Uruguay. Phone: +598-2-4808472; Fax: +598-24872572Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilDepartment of Gastroenterology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilDepartment of Gastroenterology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilGraduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilDepartment of Gastroenterology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilGraduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilDepartment of Gastroenterology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, UruguayGraduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilGraduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Division of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, BrazilIntroduction and Aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital. Materials and Method: Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure. Results: From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death. Conclusion: PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk. Conflict of interest statement: The authors have nothing to disclose.http://www.sciencedirect.com/science/article/pii/S1665268121000764Liver diseasesdrug-induced liver injuryacute-on-chronic liver failureacute liver failure |