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Hepatotoxicity What is it? Dr. B. K. Iyer
Liver: An Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Blood Supply to The Liver ,[object Object],[object Object],[object Object]
Major Cell Types ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Liver Lobule: An Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Oxygenation Zones ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hepatotoxicity: What is it? ,[object Object],[object Object]
Types of Liver Injury Fatty degeneration Canalicular cholestasis Hepatocellular death More ,[object Object],[object Object],due to transport mechanism damage due to mitochondrial damage Next page Types of liver injury
Types of Liver Injury Fatty degeneration Bile duct / Sinusoidal damage Liver architecture Damage Cirrhosis ,[object Object],[object Object],[object Object],[object Object],Microtubular “scaffolding” collapse leading to deformation of hepatocyte irreversible fibrosis of liver Types of liver injury
[object Object],[object Object]
Uptake of Toxic Substances ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Uptake of Toxic Substances ,[object Object],[object Object]
Uptake of Toxic Substances ,[object Object],[object Object],[object Object],[object Object]
Defining DIH due to anti-TB drugs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Incidence of DIH ,[object Object],[object Object],[object Object]
DIH: Fatality rates ,[object Object],[object Object]
Risks for DIH ,[object Object],[object Object],[object Object],[object Object]
Risks for DIH ,[object Object],[object Object]
Risks for DIH ,[object Object],[object Object]
RIF and DIH ,[object Object],[object Object],[object Object]
PZA and DIH ,[object Object],[object Object]
INH and DIH ,[object Object],[object Object],[object Object]
Signs / Symptoms of DIH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
High risk cases for DIH ,[object Object],[object Object],[object Object]
High risk cases for DIH ,[object Object],[object Object]
Diagnosis of DIH due to anti-TB drugs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria of DIH ,[object Object],[object Object]
Criteria of DIH ,[object Object],[object Object]
Management of DIH Monitor for a fortnight. If clinically,there is no problem and LFT shows no rise, increase to full dose. Add INH in half dose Monitor for a fortnight. If clinically,there is no problem and LFT shows no rise, increase to full dose. Add PZA in half dose Monitor for a fortnight. If clinically,there is no problem and LFT shows no rise, increase to full dose. Add rifampicin in half dose Monitor LFT and wait for normalisation Start streptomycin and ethambutol Perform LFT Stop all anti-TB drugs Follow-up Action
Thank you!

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Hepatotoxicity

  • 1. Hepatotoxicity What is it? Dr. B. K. Iyer
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  • 29. Management of DIH Monitor for a fortnight. If clinically,there is no problem and LFT shows no rise, increase to full dose. Add INH in half dose Monitor for a fortnight. If clinically,there is no problem and LFT shows no rise, increase to full dose. Add PZA in half dose Monitor for a fortnight. If clinically,there is no problem and LFT shows no rise, increase to full dose. Add rifampicin in half dose Monitor LFT and wait for normalisation Start streptomycin and ethambutol Perform LFT Stop all anti-TB drugs Follow-up Action

Editor's Notes

  1. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  2. This graph shows the direct correlation between the lowering of the CD4 count and the acquisition of opportunistic infections.
  3. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  4. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  5. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  6. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  7. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  8. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  9. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  10. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  11. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  12. These organisms can take advantage of the “opportunity” provided by the defective or weakened immune system that results from HIV/AIDS. The resulting illnesses are usually more severe in HIV/ AIDS patients than in people with normal immune systems. When a person is first found to be HIV positive, immunizations are given to help decrease the number of opportunistic infections. These immunizations include: Pneumovax Influenza vaccine Hepatitis B vaccine Tetanus-diphtheria
  13. This graph shows the direct correlation between the lowering of the CD4 count and the acquisition of opportunistic infections.