DRUG-INDUCED LIVER INJURY-DILI AND HILI IN CLINICAL PRACTICE

Abstract

Drug-induced liver damage is still a problem for modern medicine. On the one hand, it is related to the polyprogression found mainly in the elderly and chronically ill, and on the other hand, to the fashion for young people to use dietary supplements and herbs. The course of DILI can range from a mild, asymptomatic, reversible increase in liver parameters to severe liver failure leading to hepatic encephalopathy, multiple organ failure and death of the patient. It is one of the most common causes of acute liver injury, accounting for 10-50% of cases and is responsible for 30-70% of cases of acute liver failure, sometimes posing a real threat to the patient's health and life.

Prevention of DILI should be based on the identification of risk factors, appropriate drug selection and patient education, avoidance of self-medication, with periodic review of patients' pharmacotherapy. Prevention of DILI requires the cooperation of the physician, pharmacist and patient, sometimes also the patient's family or carers. Knowing the initial clinical signs and systematically performing control tests of liver parameters (ALT, AST, ALP, bilirubin) can reduce the risk of severe forms of drug-induced liver damage. The article outlines the aetiology, methods of diagnosis, monitoring and treatment of DILI.