الأدوية التي تؤثر على وظائف الكبد والتي تسبب أمراض الكبد

الأدوية
التي تؤثر على وظائف الكبد والتي تسبب أمراض الكبد.أرجو التثبيت الأدوية التي تؤثر على وظائف الكبد والتي تسبب أمراض الكبد Smile

هناك الكثير من الأدوية التي تؤثر على
وظائف الكبد وتسبب له العديد من المشكلات
يعني
DRUGS INDUCED
HEPATOTOXICITY
والتي تتطلب منا عند تعاطيها Liver
Screening and monitoring for Liver functions enzymes and liver injury.
فما هذه
الأدوية؟
سأبدأ أنا أولا بأدوية السكر:

بسم الله
الرحمن الرحيم

Hepatotoxicity
in the Diabetic Population

مرض السكري
بنوعيه مرتبط بعدة مضاعفات خطيرة مثل:
as
cardiopathy, nephropathy, and retinopathy .
,وبالرغم ان
HEPATOTOXICITY هي أهم مضاعفات ومشاكل أدوية السكر
أدوية
السكر المرتبطة ب hepatotoxicityهي:

include
sulfonylureas, alpha-glucosidase inhibitors, biguanides, and
thiazolidinediones.
أولا:

Drug
induced hepatotoxicity has been reported occasionally :
with second-generation
sulfonylureas. Second-generation sulfonylureas include glipizide,
glibenclamide and glimepiride.
ثانيا:

For alpha-glucosidase inhibitors, the most well-known of
this class is acarbose. It is minimally absorbed in unchanged form
after oral administration, therefore, this drug is widely believed to be
safe. However, there were cases of severe hepatotoxicity reported for
acarbose
ثالثا:

Biguanides
(metformin) is widely used for the treatment of type 2 diabetes. A
serious but rare side effect,lactic acidosis, is caused because of
its interference with mitochondrial oxidative processes. For
hepatotoxicity, only one or two cases reported so far.

رابعا:

Thiazolidinediones
(TZDs, also known as glitazones) are insulin sensitizers now widely used
for the treatment of type 2 diabetes. Three TZDs are being used in
clinical practice: troglitazone, pioglitazone, and rosiglitazone.

Troglitazone
is a peroxisome proliferators–activated receptor gamma agonist that
enhances insulin sensitivity. Within one year after its widespread use,
individual cases of liver injury and failure were reported. The mounting
evidence for the idiosyncratic hepatotoxicity of troglitazone in the
following years led to its withdrawal from the market in 2000.

Well, antidiabetic drugs are to be taken for long
term, for life. For this reason, diabetic patients that are taking drug
therapies should be monitored regularly. Although till now, antidiabetic
drugs are still relatively 'liver-friendly', recent epidemiological
studies suggested that patients with diabetes are twice as likely to
suffer hepatic failure compared to patients who do not have diabetes.
Increased incidences of hepatotoxicity have been observed in patients
with diabetes receiving drug therapies.

We are not sure what is the mechanism or the
predisposing factors for the hepatotoxicity in diabetic patients with
drug therapies.

It is recommended that diabetic patients with drug
therapies should have their liver function tests (LFT) regular (perhaps annually, or twice per year

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