Across
- 5. Product of hemoglobin breakdown that is conjugated with glucuronic acid in the liver before biliary excretion.
- 7. Classification of unpredictable drug-induced liver injury that is generally unrelated to dose and may develop days to months after exposure.
- 10. Intravenous formulation of acetylcysteine administered in a traditional three-infusion regimen totaling 300 mg/kg over 21 hours.
- 11. Endogenous antioxidant involved in detoxifying the reactive metabolite of acetaminophen.
- 12. Reactive acetaminophen metabolite formed through cytochrome P450 metabolism that can cause hepatocellular injury when glutathione stores become depleted.
- 16. Antidote for acetaminophen poisoning that replenishes glutathione stores through provision of cysteine.
- 18. Calculation using ALT and alkaline phosphatase relative to their upper limits of normal to classify the pattern of liver injury.
- 19. Enzyme originating from the liver and bone that becomes elevated with impaired biliary tract function and has a half-life of approximately seven days.
- 20. Pattern of drug-induced liver injury characterized by predominant ALT elevation and an R-ratio greater than five.
- 22. NSAID associated with a five- to tenfold greater risk of hepatotoxicity compared with other medications in its class.
- 24. Pattern of drug-induced liver injury involving both ALT and alkaline phosphatase elevations, with an R-ratio between two and five.
- 25. FDA reporting system used to document suspected medication-related adverse events, including drug-induced liver injury.
- 26. Biliary enzyme without a bone origin that helps determine whether an elevated alkaline phosphatase is hepatic in origin.
- 29. Neurologic complication in infants associated with elevated unconjugated bilirubin concentrations.
- 30. Nomogram used to assess the need for acetylcysteine treatment based on serum acetaminophen concentration and time after a single acute ingestion.
- 31. Analgesic and antipyretic responsible for dose-dependent hepatotoxicity through formation of a reactive metabolite.
- 32. Brand-name combination antibiotic associated with cholestatic liver injury and elevated alkaline phosphatase and bilirubin.
- 33. Medication class for which the FDA eliminated routine periodic liver enzyme monitoring in 2012, recommending baseline testing and subsequent testing when clinically indicated.
- 34. Antituberculosis medication associated with hepatocellular injury, with approximately 15–20% of patients experiencing elevated liver function tests according to the lecture.
Down
- 1. Online resource recommended for reviewing medications associated with drug-induced liver injury and their characteristic hepatotoxicity patterns.
- 2. Antimetabolite associated with cumulative hepatic toxicity and fibrosis through activation of hepatic stellate cells.
- 3. Gastrointestinal decontamination agent described as more effective than gastric lavage for reducing acetaminophen absorption.
- 4. Antiarrhythmic medication associated with cumulative-dose hepatotoxicity and drug-induced steatohepatitis.
- 6. NSAID associated with an increased risk of hepatotoxicity, typically developing within six to twelve weeks after initiation.
- 8. Antifungal medication associated with cholestatic hepatotoxicity, with an estimated incidence of approximately one in 50,000 patients in the lecture.
- 9. Aminotransferase found in the liver, heart, kidneys, brain, and muscle, with an AST-to-ALT ratio greater than two suggesting alcoholic liver disease.
- 13. Liver-synthesized clotting factor whose associated laboratory measurement helps assess hepatic synthetic function.
- 14. Marker of hepatic synthetic function with a relatively short half-life of approximately two days.
- 15. Patients who initially develop transient liver injury following medication exposure but subsequently demonstrate biochemical improvement.
- 17. Impairment or reduction of bile flow associated with elevated alkaline phosphatase and bilirubin concentrations.
- 21. Anticonvulsant associated with mixed-pattern liver injury and immunoallergic hepatotoxicity involving enzyme-drug adducts.
- 23. Aminotransferase enzyme more specific for hepatocellular injury than AST, also known as SGPT.
- 27. Brand-name acetylcysteine formulation discussed as an antidote for acetaminophen toxicity.
- 28. Principle identifying hepatocellular injury accompanied by jaundice as a warning sign for potentially severe or fatal drug-induced liver injury.
- 31. Type of reaction associated with intravenous acetylcysteine, occurring in approximately 5–10% of patients according to the lecture.