The liver is one of the vital internal organs. It is located in the abdominal cavity under the diaphragm. The liver is an unpaired organ. It performs many different functions. In particular, it protects the body from the damaging effects of toxins, foreign substances, allergens and other harmful compounds.
Deactivation mechanism
Inactivation of compounds is the process of their chemical modification. It consists of two stages. In the first phase, the compound undergoes oxidation (electrons are detached). At the second stage, the substance undergoes hydrolysis or reduction (electron addition). At the second stage, another substance joins the formed chemical active groups. As a result, the harmful compound is converted into a less toxic or harmless and easily excreted from the body. But in some cases, the body ceases to cope with its functions.
Cause of toxic hepatitis
Liver damage may be due toa number of factors. It can occur as a result of parenteral administration or ingestion of chemical or pharmacological substances, inhalation. Among the toxic compounds, industrial poisons and some types of fungi are dangerous. Pharmacological agents used to treat various pathologies have a strong effect on the liver. Drug poisoning can occur, in turn, due to a number of reasons. One of the main ones is their uncontrolled intake.
Types of poisoning effects
Distinguish between direct negative influence and idiosyncrasy. In the second case, the effect of the poisonous compound depends on the dose. With prolonged use of drugs, chronic toxic hepatitis may develop as a result. Treatment with many medicines is a serious threat to he alth. Most drugs are metabolized in the liver, resulting in the breakdown of funds. The resulting products provoke morphological changes. Higher doses of drugs produce more active harmful metabolites that cause serious liver damage.
Course of pathologies
Usually the latent (hidden) period is short. In some cases, it is only a few hours. Clinical signs meanwhile appear after a day or two. Acute toxic hepatitis can be triggered by systemic poisons or decay products formed in the liver. For each poisonous compoundcharacterized by its negative impact. For example, trichlorethylene, carbon tetrachloride cause necrotic processes, and yellow phosphorus leads to periportal damage. With daily intravenous administration of Tetracycline at a dose of more than 1.5 g, small fatty deposits are formed in the liver. In some cases, the damaging effect goes unnoticed for a certain period until jaundice appears.
Idiosyncratic reactions
Hepatitis is rare and unpredictable in these cases. Its severity depends on the dosage. A pathological condition can develop at any time during or after taking the medication. Symptoms of toxic hepatitis are usually of the same type. In particular, with idiosyncrasy, extrahepatic hypersensitivity reactions are noted: rash, fever, arthralgia. In patients, in almost 25% of cases, eosinophilia and leukocytosis are observed. In the course of a number of studies, it was found that the hepatotoxic effect in such conditions is due to the activity of the formed metabolites of pharmacological agents.
Diagnosis of conditions
Specialists note that not all hepatic reactions that occur when taking certain drugs are classified as idiosyncratic or toxic. For example, oral contraceptives (gestagens, estrogens) can cause liver dysfunction, and in some cases jaundice. But these medicines do not cause necrotic processes orfat changes. In this case, the manifestation of a hypersensitivity reaction can be considered as genetically predetermined. Due to the fact that the diagnosis is presumptive in most cases, and against the background of other pathologies there is a similar clinical picture, it is sometimes difficult for a specialist to establish causal relationships between the use of specific drugs and subsequent liver damage. In some cases, the symptoms of toxic hepatitis can be reproduced. At the same time, provocation with a suspected drug after a latent period causes a number of signs, biochemical and morphological changes. However, this kind of artificial provocation is in many cases impossible for aesthetic reasons, as well as due to the high risk of developing severe complications. Toxic drug-induced hepatitis, the treatment of which should be mainly supportive, is manifested primarily by adverse reactions to the drug. When diagnosing a suspected drug, it must be immediately canceled. At the same time, during the examination, the specialist should not be distracted from damage to the kidneys and other organs. Along with changes in the liver, damage to other organs can eventually lead to death.
Therapeutic interventions
Toxic hepatitis symptoms range from mild hypersensitivity reactions to severe conditions. Depending on the clinical picture, therapeutic measures are also prescribed. So, for example, with vomiting and severeanorexia treatment of toxic hepatitis includes intravenous drip of a glucose solution (five or ten percent) at a dose of up to 500 milliliters. If signs of coma or liver congestion are detected, massive plasmapheresis is performed. With the help of a separator or centrifuge, 1.5-2 liters of existing plasma is removed and two liters of frozen plasma are injected intravenously. In the absence of improvement, an increase in the level of prothrombin, the preservation of impaired consciousness, the procedure is repeated. Before the normalization of the coagulation system, 1-2 liters of fresh frozen plasma are injected every day for 2-3 days. Therapeutic measures include diet. With toxic hepatitis, food enriched with carbohydrates, fruit juices in large quantities are recommended. The patient should be restricted from taking fat.
Therapeutic interventions without exacerbations
Significant clinical significance in the choice of measures that make up the treatment of toxic hepatitis of a long-term nature is the factor that provoked the pathological condition. With prolonged liver damage, moderately pronounced fibrosis and a predominantly preserved lobular structure of the organ are noted. In the absence of exacerbation, the treatment of toxic hepatitis provides for a special diet. Spices, spicy dishes, fried foods, refractory fats are excluded from the diet. Recommended daily consumption of cottage cheese (up to 100-150 g), boiled low-fat fish, mild cheese. Treatment of toxic hepatitis in some cases is carried out in combination with the treatment of alcoholism (with alcohol poisoning). It is extremely important to ensure absolutetermination of contact with the poisonous substance.
Therapy for exacerbations
In such conditions, hospitalization is recommended, a more strict diet. With toxic hepatitis, bed rest is necessary. Patients are prescribed vitamins mainly of the B-group, as well as folic, nicotinic, ascorbic acid. To improve the course of anabolic processes, steroid hormones are used (orally - methandrostenol per day, 15-20 mg, with a gradual decrease in dosage, or intramuscularly retabolil once every two weeks, 20-50 mg). In more severe conditions, corticosteroid hormones are recommended (Prednisolone 20-40 mg / day), immunosuppressants - for a long time, but in a small dosage.
Toxic hepatitis. Treatment with folk remedies
To alleviate the condition, there are several recipes using herbal ingredients. So, sauerkraut juice is effective. With a long course of the disease, it is recommended to drink half a glass a day. Duration of admission - not less than a month. Another fairly popular remedy is horseradish tincture. For its preparation, take 2 tbsp. l. grated raw materials, pour milk. The mixture should be heated to a boil, remove from heat, cool. Take during the day in small sips. Duration - until the condition improves. Mint (leaf) tincture helps reduce symptoms. 2 tbsp. l. plants are poured with 2 cups of boiling water. The solution is infused for a day. Drink the remedy up to three times a day.
Prevention measures
The main measures to prevent the development of pathological conditions are to carefully observe the rules of hygiene. Do not eat inedible or edible, but old mushrooms or other foods that have expired. As noted above, one of the main causes of toxic liver damage is the intake of high doses of medications. When prescribing potent drugs, the use of which is associated with the risk of hypersensitivity reactions and other complications, it is necessary to follow the doctor's instructions and follow the recommendations in the annotations to the drugs. It is strongly not recommended to change the therapy regimen on your own. With the development of pathological conditions associated with impaired liver function, it is necessary to immediately visit a specialist and receive qualified assistance.
