Drug-Induced Hepatotoxicity

Always consider drug toxicity in the presence of jaundice or abnormal liver biochemistry. This often means obtaining a detailed drug history from the GP and asking family members about herbal remedies and over-the-counter medication. Acute liver failure has frequently been reported following anti-tuberculous therapy. Although there is usually a very clear temporal association between taking the drug and the onset of hepatotoxicity, halothane and co-amoxiclav may present up to three weeks after taking the drug. Prognosis is worse than with liver failure secondary to acute viral hepatitis.

While the mainstay of treatment is supportive, the need for transplanataion should be borne in mind, and early discussions should take place with a transplant unit.