Hepatotoksilised

Hepatotoksilised is an Estonian term used to describe substances that can cause liver injury, i.e., hepatotoxic agents. Hepatotoxicity refers to liver damage resulting from chemical, drug, or toxin exposure. The spectrum ranges from mild enzyme elevations to fulminant liver failure, and the pattern of injury can be hepatocellular, cholestatic, or mixed.

Mechanisms of hepatotoxicity include direct cellular toxicity, immune-mediated injury, and metabolic activation that produces harmful metabolites. The clinical presentation varies and may be asymptomatic or present with jaundice, fatigue, nausea, and right upper quadrant pain. Laboratory patterns are used to categorize injury: hepatocellular injury shows predominant elevations of alanine and aspartate aminotransferase (ALT/AST), cholestatic injury shows elevated alkaline phosphatase (ALP) and bilirubin, and mixed patterns involve features of both.

Common causes of hepatotoksilised injury include acetaminophen overdose, chronic alcohol use, and various prescription drugs such as isoniazid, amoxicillin-clavulanate, methotrexate, and valproic acid. Herbal and dietary supplements, including some traditional medicines, can also be hepatotoxic. Diagnosis relies on clinical history, laboratory tests, exclusion of other liver diseases, and sometimes causality assessment tools. Liver biopsy is rarely required but may be used in uncertain cases.

Management centers on avoiding further exposure and providing supportive care. Specific treatment exists for acetaminophen toxicity with N-acetylcysteine; severe cases may require intensive care or liver transplantation. Prevention focuses on prudent drug dosing, monitoring, avoiding concurrent hepatotoxins, and educating patients about potential risks.