Hepatotoxic effects of some commonly used drugs

In addition to the usual association with insulin resistance, type II diabetes, central obesity, and hypertriglyceridaemia, nonalcoholic steatohepatitis (NASH) has been associated with several drugs and toxins. Druginduced steatohepatitis is usually the result of prolonged therapy. It resembles alcoholic liver disease more closely than NASH associated with diabetes and the insulin resistance syndrome. The toxic mechanism appears to involve mitochondrial injury, which causes steatosis because of impaired β-oxidation of fatty acids, and leads to generation of reactive oxygen species and ATP depletion. If a drug is suspected, it is important to determine the dose, route, and duration of therapy, as well as possible interactions.