Effects of Rifampin and Isoniazid on the Isolated Perfused Rat Liver

Oliven, Arie; Bassan, H

doi:10.1159/000238408

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…RFP is known to interact with the metabolism of other drugs (e.g., oral contraceptives), especially via enterohepatic circulation (16). In an animal model, the effects of RFP on the bile flow were biphasic: low-dose RFP increased the bile duct flow, while high-dose RFP decreased the bile duct flow (17). In this scenario, high-dose RFP increases the serum concentrations of RFP and serum bilirubin, which may result in a vicious cycle.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Liver Injury with an Elevated Serum Bilirubin Concentration Caused by Antituberculous Drugs

et al. 2013

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Objective No studies have so far sufficiently investigated the risk factors for drug-induced liver injury (DILI) with an elevated serum bilirubin concentration. Methods We conducted a historical cohort study observing inpatients admitted to two hospitals in Japan. A decreased level of activities of daily living (ADL) was defined as a Barthel Index score of <80. The patients were treated with standard regimens under a directly observed treatment short-course strategy. Results The cohort of 356 patients comprised 244 men (68.5%) and 112 women (31.5%), with a mean age of 63.8±20.2 years. Compared with the patients who did not experience DILI with a bilirubin level of ! 2.0 mg/dL, the patients who experienced DILI with a bilirubin level of ! 2.0 mg/dL more often had a decreased level of ADLs, were more likely to suffer from chronic cardiac disease, had lower serum albumin levels and were less often treated with four-drug regimens involving pyrazinamide (PZA). In a logistic regression analysis in which these five factors acted as independent variables, a decreased level of ADLs was the strongest predictor for DILI with a bilirubin level of ! 2.0 mg/dL, with an odds ratio of 16.5 (95%CI: 1.7-159; p= 0.015), followed by chronic cardiac disease, with an odds ratio of 4.0 (95%CI: 1.2-12.6; p=0.020). Conclusion A decreased level of ADLs and chronic cardiac disease are strong risk factors for DILI with a bilirubin level of ! 2.0 mg/dL resulting from the use of antituberculous drugs. Physicians should pay close attention to the possibility of DILI with a bilirubin level of ! 2.0 mg/dL when treating tuberculosis patients with a decreased level of ADLs and/or chronic heart disease.

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Section: Discussionmentioning

confidence: 99%