Toxic hepatitis is liver inflammation caused by toxic agents, including drugs, alcohol, industrial chemicals, and certain plants. Symptoms can manifest within 24 to 48 hours of exposure, with diagnostic tests revealing liver enzyme abnormalities and potentially necessitating treatments like removal of the toxic agent and monitoring of vital signs. Prevention strategies emphasize cautious use of medications, awareness of herb interactions, and precautions when handling chemicals.

1. KALULUSHI COLLEGE OF NURSING
Mr Mulundano M. L
BSCNs-UNZA
KCN-Lecture
Mr Mulundano M. L
BSCNs-UNZA
KCN-Lecture
Management
of
Toxic hepatitis
JANUARY 2019 INTAKE

2. Toxic hepatitis
• Defined as; The inflammation of the
liver caused by toxic agent.
• The toxic agent may include:
o Drugs like acetaminophen, pyrazinamide,
etc.
o Alcohol
o Industrial toxins such as carbon
tetrachloride from dry cleaning agents.
Insecticides.
o Plant poisons like mushroom, and bush teas

3. • Alcohol. Heavy drinking over many years can
lead to alcoholic hepatitis — inflammation in
the liver due to alcohol, which can lead to liver
failure.
• Over-the-counter pain
relievers. Nonprescription pain relievers such
as acetaminophen (Tylenol, others), aspirin,
ibuprofen (Advil, Motrin IB, others) and
naproxen (Aleve, others) can damage your
liver, especially if taken frequently or
combined with alcohol.

4. • Prescription medications. Some
medications linked to serious liver injury
include the statin drugs used to treat
high cholesterol, the combination drug
amoxicillin-clavulanate (Augmentin),
phenytoin (Dilantin, Phenytek),
azathioprine (Azasan, Imuran), niacin
(Niaspan), ketoconazole, certain
antivirals and anabolic steroids. There
are many others.

5. • Herbs and supplements. Some
herbs considered dangerous to the
liver include aloe vera, black
cohosh, cascara, chaparral,
comfrey, kava and ephedra. There
are many others. Children can
develop liver damage if they
mistake vitamin supplements for
candy and take large doses.

6. • Industrial chemicals. Chemicals you
may be exposed to on the job can cause
liver injury. Common chemicals that can
cause liver damage include the dry
cleaning solvent carbon tetrachloride, a
substance called vinyl chloride (used to
make plastics), the herbicide paraquat
and a group of industrial chemicals
called polychlorinated biphenyls.

7. Clinical manifestations
of Toxic hepatitis
• Following exposure to these agents, liver
damage occurs within 24 to 48 hours,
depending on the size of the dose and the
degree of exposure.
• Anorexia, Nausea, Vomiting, Dark urine,
Jaundice, Hepatomegaly
• Possible abdominal pains with acute onset
and necrosis.
• Carbon tetrachloride poisoning also produces
headache, dizziness, drowsiness and vaso
motor collapse.

8. Diagnostic findings
• Physical exam and medical
history; will show signs of hepatitis
and history of exposure to toxic
substances. Medications taken,
including over-the-counter drugs
and herbs, whether the client works
with industrial chemicals or may
have been exposed to pesticides,
herbicides or other environmental
toxins.

9. • Blood tests. blood tests that
analyze the levels of liver enzymes
and bilirubin in the blood. Bilirubin is
a waste product made from old
blood cells. If blood levels of liver
enzymes and bilirubin are higher
than normal, it can indicate liver
damage

10. • Imaging tests. Magnetic
resonance imaging
(MRI), computed tomography
(CT) or ultrasound scans may be
ordered to evaluate liver damage.

11. • Liver biopsy. A liver biopsy can
help confirm the diagnosis of toxic
hepatitis and help exclude other
causes. The sample is examined
under a microscope. to evaluate the
type and extent of liver damage

12. Diagnostic findings
• Include high serum levels of; WBC
count and eosinophil count,
aspartate aminotransferase and
alanine amino transferase, total and
direct bilirubin.
• Liver function tests have little effect
in identifying the cause

13. Treatment
• Treatment includes removal of the
causative agent, gastric lavage, or
hyperventilation depending on the
route of exposure.
• Monitor laboratory studies and note
trends..

14. • Monitor patient’s vital signs and
provide support to maintain vital
functioning depending on the
severity of the symptoms

15. • Instruct patient on proper use and
handling of cleaning agents and
solvents.
• Where there is a known treatment
for the poison it may be given
• For instance for Acetaminophen
over dose, Acetyl cysteine will be
given

16. PREVENTION
• Limit medications. Take
prescription and nonprescription
drugs only when absolutely
necessary. Investigate nondrug
options for common problems such
as high blood pressure, high
cholesterol and arthritis pain.

17. • Take medications only as
directed. Follow the directions
exactly for any drug you take. Don't
exceed the recommended amount,
even if your symptoms don't seem
to improve. Because the effects of
over-the-counter pain relievers
sometimes wear off quickly, it's
easy to take too much.

18. • Be cautious with herbs and
supplements. Don't assume that
a natural product won't cause
harm. Discuss the benefits and
risks with your doctor before
taking herbs and supplements.

19. • The National Institutes of Health
maintains the LiverTox website,
where you can look up medications
and supplements to see if they're
linked to liver damage.

20. • Don't mix alcohol and
drugs. Alcohol and medications are
a bad combination. If you're taking
acetaminophen, don't drink alcohol.
Ask your doctor or pharmacist about
the interaction between alcohol and
other prescription and
nonprescription drugs you use.

21. • Take precautions with chemicals. If
you work with or use hazardous
chemicals, take all necessary
precautions to protect yourself from
exposure. If you do come in contact with
a harmful substance, follow the
guidelines in your workplace, or call your
local emergency services or your local
poison control center for help.

22. • Keep medications and chemicals
away from children. Keep all
medications and vitamin
supplements away from children
and in childproof containers so that
children can't accidentally swallow
them.

23. Complications of
hepatitis
• Chronic hepatitis
• Hepatic coma
• Liver cirrhosis
• Cancer of the liver
• Acute hepatic necrosis

24. KALULUSHI COLLEGE OF NURSING
Mr Mulundano M. L
BSCNs-UNZA
KCN-Lecture
Mr Mulundano M. L
BSCNs-UNZA
KCN-Lecture
CONGRATULATIONS!
THE END