Tradução E Validação De Algoritmo Para Identificação De Lesão Hepática Induzida Por Medicamentos

Lunardelli, Michele John Müller; Becker, Matheus William; Blatt, Carine Raquel

doi:10.21527/2176-7114.2020.40.226-235

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…The use of the updated Roussel Uclaf Causality Assessment Method (RUCAM) algorithm is recommended by specialists to evaluate DILI, since it is the most reliable and reproducible validated method correlating liver damage to drug and herb use (23). Although RUCAM has been used worldwide for 25 years, only in 2020 it was validated for use in Brazilian Portuguese 24 .…”

Section: Introductionmentioning

confidence: 99%

Drug-induced liver injury causality assessment data from a crosssectional study in Brazil: a call for the use of updated RUCAM in hospital Pharmacy

LUNARDELLI¹,

Becker²,

ORTIZ³

et al. 2022

Rev Bras Farm Hosp Serv Saude

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Objective: to identify the frequency of DILI inpatients from abnormal liver enzyme levels using the updated Roussel Uclaf Causality Assessment Method (RUCAM) causality assessment algorithm, as well as to provide a descriptive analysis of DILI cases. Methods: we conducted a crosssectional study in a medium complexity hospital in southern Brazil. Data regarding DILI was collected retrospectively from electronic medical records (EMR) in 2015. Inclusion criteria were all adult patients (≥ 18 years old) who presented alanine aminotransferase (ALT) greater than twice the superior limit of normality (ALT > 60 UI/L) with concomitant change of aspartate aminotransferase (AST) or alkaline phosphatase (ALP) or change of ALP greater than twice the superior limit of normality (ALP > 250 UI/L) during hospitalization. The RUCAM was applied to all suspected DILI cases. Results: 84,134 inpatients in this period; 178 patients had abnormal liver tests, six patients had sufficient medical information to allow DILI causality assessment, and two patients had DILI described in EMR, although our group could not find suficient information to apply RUCAM retrospectively. Absence of information was mainly related to drug reconciliation at hospital admission, time of onset of suspected drug therapy and no description of previous clinical conditions in EMR. Four patients developed hepatic injury as a result of drug treatment initiated during hospitalization. Suspected drugs were antibiotics, nonsteroidal anti-inflammatory drugs, antiviral, tuberculostatics and platelet antiaggregant. Liver injury pattern was identified as hepatocellular and mixed. Conclusion: DILI appeared as a rare ADR, but absence of data in most EMR affected the application of RUCAM and underestimated DILI frequency. There is an urgency to develop DILI knowledge in Brazilian hospitals. Pharmacists must be aware of the use of the updated RUCAM to prospectively assess possible DILI cases. For future research, we suggest to combine cross-linking DILI tracers such as ICD-10 liver injury codes, abnormal liver biomarkers, search for trigger hepatotoxicity drugs and EMR text search tools, adding artificial intelligence to pharmacovigilance and hospital pharmacy.

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Section: Introductionmentioning

confidence: 99%

Drug-induced liver injury causality assessment data from a crosssectional study in Brazil: a call for the use of updated RUCAM in hospital Pharmacy

LUNARDELLI¹,

Becker²,

ORTIZ³

et al. 2022

Rev Bras Farm Hosp Serv Saude

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“…Introdução hepatite medicamentosa, também conhecida como lesão hepática induzida por medicamentos ou Drug Induced Liver Injury (DILI), constitui uma forma de reação adversa a medicamentos (Lunardelli et al, 2020). Podendo se manifestar dentro de um período de um a noventas dias após a administração de um medicamento (Silva et al, 2023).…”

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Hepatoprotective Effect of Merlot Grape Pomace Extract against Acetaminophen-Induced Damage in Mouse

Spader,

Carvalho,

Oliveira Gamba

et al. 2024

GJHSS

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This study investigated the benefits of Merlot grape pomace extract (EBUM) in experimental acetaminophen-induced intoxication. Swiss mice received the respective treatments for 7 days: Control (saline), Silymarin (100 mg/Kg), EBUM: 100 mg/Kg and 500 mg/Kg. On the seventh day, the acetaminophen control,Silymarin and EBUM received a single dose of acetaminophen 500 mg/kg. After 24 hours, the mice were sacrificed, the blood and liver were collected for analysis of serum transaminases (ALT and AST), bilirubin, hepatic markers of oxidative stress and histopathological analysis. EBUM was able to prevent acetaminophen-induced hepatic necrosis with a significant reduction (p<0.0001) in ALT and AST, bilirubin, as well as a significant increase in hepatic GSH and CAT levels. The histological data are consistent with the transaminase results, showing less liver damage in the treated groups when compared to the acetaminophen group. The results allow us to infer that EBUM has a hepatoprotective effect against intoxication caused by acetaminophen in animal model, proving to be a therapeutic alternative in preventing drug-induced liver damage.

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Riscos hepáticos provenientes da automedicação

Conceição¹,

Almeida²,

Xiscatti³

et al. 2020

Revista Científica Multidisciplinar Núcleo do Conhecimento

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A automedicação se caracteriza pela administração de substâncias medicamentosas, para aliviar sintomas ou tratar patologias, sem prescrição médica ou orientação de um profissional da saúde, o que pode comprometer a função do fígado ou causar um dano hepático mais grave. O objetivo deste trabalho foi analisar a incidência de automedicação e seus fatores de riscos ao fígado. Foi realizado uma revisão de literatura, através de buscas em revistas eletrônicas disponíveis nas bases de dados Scientific Eletronic Library Online (SciELO), Revista Eletrônica Biociências, Biotecnologia e Saúde, PubMed e Google Academic, em artigos publicados entre os anos de 2015 a 2020. Após análise dos artigos incluídos na revisão, os resultados contribuem para o perfil de risco sobre a hepatotoxidade dos medicamentos utilizados de forma irracional. Portanto, tornam-se necessárias medidas preventivas de modo a contribuir com a redução do consumo desenfreado e ao mesmo tempo que seja incentivada a população a procurar um profissional da saúde.

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Tradução E Validação De Algoritmo Para Identificação De Lesão Hepática Induzida Por Medicamentos

Cited by 4 publications

References 7 publications

Drug-induced liver injury causality assessment data from a crosssectional study in Brazil: a call for the use of updated RUCAM in hospital Pharmacy

Drug-induced liver injury causality assessment data from a crosssectional study in Brazil: a call for the use of updated RUCAM in hospital Pharmacy

Hepatoprotective Effect of Merlot Grape Pomace Extract against Acetaminophen-Induced Damage in Mouse

Riscos hepáticos provenientes da automedicação

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