Prospective Monitoring of Drug Use: Drug-Induced Liver Injury in a Primary Healthcare Center

Prado, Nília Maria de Brito Lima; Messias, Gladistone Correia; Santos, Genário; Nunes, Vinícius; Schinonni, Maria Isabel; Paraná, Raymundo

doi:10.1590/s0004-2803.201900000-73

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…Hepatotoxicity is another serious complication that has been linked to NSAIDs although the incidences are less frequent compared to that of gastrointestinal damage, CVD and renal insufficiency. In line with that, a recent study in Brazil, conducted in the primary health care units, inferred drug-induced-liver-injury as a rare event [187]. However, the seriousness of the issue lies elsewhere.…”

Section: Risk Of Hepatotoxicitymentioning

confidence: 75%

Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective

Bindu

Mazumder

Bandyopadhyay

2020

Biochemical Pharmacology

747

399

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Owing to the efficacy in reducing pain and inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) are amongst the most popularly used medicines confirming their position in the WHO's Model List of Essential Medicines. With escalating musculoskeletal complications, as evident from 2016 Global Burden of Disease data, NSAID usage is evidently unavoidable. Apart from analgesic, anti-inflammatory and antipyretic efficacies, NSAIDs are further documented to offer protection against diverse critical disorders including cancer and heart attacks. However, data from multiple placebo-controlled trials and meta-analyses studies alarmingly signify the adverse effects of NSAIDs in gastrointestinal, cardiovascular, hepatic, renal, cerebral and pulmonary complications. Although extensive research has elucidated the mechanisms underlying the clinical hazards of NSAIDs, no review has extensively collated the outcomes on various multiorgan toxicities of these drugs together. In this regard, the present review provides a comprehensive insight of the existing knowledge and recent developments on NSAID-induced organ damage. It precisely encompasses the current understanding of structure, classification and mode of action of NSAIDs while reiterating on the emerging instances of NSAID drug repurposing along with pharmacophore modification aimed at safer usage of NSAIDs where toxic effects are tamed without compromising the clinical benefits. The review does not intend to vilify these 'wonder drugs'; rather provides a careful understanding of their side-effects which would be beneficial in evaluating the risk-benefit threshold while rationally using NSAIDs at safer dose and duration.

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Section: Risk Of Hepatotoxicitymentioning

confidence: 75%

Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective

Bindu

Mazumder

Bandyopadhyay

2020

Biochemical Pharmacology

747

399

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“…In four studies, causality algorithms were used to identify the drug responsible for hepatotoxicity. The Naranjo algorithm used generically for adverse drug reactions was used in one study[ 22 - 24 ]; RUCAM, used specifically in liver injury by drugs, was used in tree studies[ 25 - 27 ]. In addition, 22 different criteria for DILI determination were identified, categorized and summarized in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

Overview of drug induced liver injury in Brazil: What is the role of public health policy on the evidence?

Becker¹,

Schwambach²,

Lunardelli³

et al. 2021

WJGPT

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BACKGROUND Adverse drug reactions are responsible for increased costs and morbidity in the health system. Hepatotoxicity can be induced both by non-prescription drugs and by those used for chronic diseases. It is the main cause of safety-related drug marketing withdrawals and could be responsible for irreversible and fatal injuries. AIM To identify and to summarize Brazilian studies reporting the drug-induced liver injury. METHODS A systematic review of Brazilian studies was carried out until June 2020. It was found 32 studies, being 10 retrospective cohorts, 12 prospective cohorts, 5 cross-sectional, 3 case-control, one case series and one randomized clinical trial. In most studies were investigated tuberculosis patients followed by other infectious conditions like human immunodeficiency virus (HIV) and hepatitis C virus. The hepatotoxicity ranged from one to 57%, led by isoniazid, rifampicin, and pyrazinamide. Few studies reported algorithm to assess causality. In most studies, there were moderate outcomes and it was necessary drug interruption. However, few severe outcomes, such as chronic liver damage and liver transplantation were reported. RESULTS Twenty-two different criteria for hepatotoxicity were found. The great heterogeneity did not allow a meta-analysis. Standardization of parameter of drug-induced liver injury and greater effort in pharmacovigilance could contribute to learn more about drug-induced liver injury (DILI)’s epidemiology in Brazil. CONCLUSION The development of strategic public health policies seems to have an influence on the DILI scientific evidence in Brazil due to main studies are in HIV and tuberculosis line care, two strategic health policies in Brazil.

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“…Ëþáîå ËÑ ìîaeåò âûçûâàòü ãåïàòîòîêñè÷íîñòü. Äëÿ ÍÏÂÑ ëåêàðñòâåííîå ïîðàaeåíèå ïå÷åíè ÿâëÿåòñÿ ðåäêèì ÿâëåíèåì [64]. Îäíàêî øèðîêîå ïðèìåíåíèå ÍÏÂÑ ïîâûøàåò àáñîëþòíóþ ÷àñòîòó äàííîé ïðîáëåìû.…”

Section: ðèñê ãåïàòîòîêñè÷íîñòèunclassified

Побочные Эффекты Нестероидных Противовоспалительных Средств И Пути Их Профилактики

Олейникова¹,

Сереброва²,

Кононова³

et al. 2022

Эксп. и клин. фармакол.

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Нестероидные противовоспалительные средства входят в число наиболее часто назначаемых лекарственных средств. Существует тенденция к еще более широкому их применению в клинической практике в связи с увеличением средней продолжительности жизни и обременением населения возраст-ассоциированными заболеваниями, в первую очередь, с болевым синдромом. При этом альтернативных обезболивающих средств, не вызывающих зависимость и имеющих доказанную эффективность, пока нет. Однако данные многочисленных исследований и мета-анализов свидетельствуют о побочных эффектах нестероидных противовоспалительных средств, включающих желудочно-кишечные, сердечно-сосудистые, печеночные, почечные, церебральные и легочные осложнения. В обзоре представлены современные представления о механизмах основных и побочных эффектов нестероидных противовоспалительных средств и последних разработках в отношении снижения их органотоксичности (химическая модификация фармакофоров). Приведенные сведения будут полезны при оценке соотношения риска и пользы в рациональном использовании нестероидных противовоспалительных средств в более безопасной дозе и продолжительности.

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Prospective Monitoring of Drug Use: Drug-Induced Liver Injury in a Primary Healthcare Center

Cited by 7 publications

References 17 publications

Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective

Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective

Overview of drug induced liver injury in Brazil: What is the role of public health policy on the evidence?

Побочные Эффекты Нестероидных Противовоспалительных Средств И Пути Их Профилактики

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