Fatty liver injury in patients with liver medication carefully
Mr. Zhu, 46, a medical examination this year, was diagnosed with hypertension and dyslipidemia. Because treatment eager, Mr. Zhu taking antihypertensive drugs in the original acid L-Amlodipine tablets at the same time, through a friend’s recommendation, to the drugstore to buy a lipid-lowering drug lovastatin, taken together with acipimox. Did not expect medication 10 days, Mr. Zhu appeared systemic fatigue, loss of appetite, jaundice, the hospital diagnosed as drug-induced hepatitis. By the Hospital Liver, back yellow, JiangMei treatment, Mr. Zhu’s symptoms gradually improved, until jaundice fade.
Why are there such a serious problem? The reason is that Mr. Zhu taking antihypertensive drugs amlodipine acid L-, and lipid-lowering drug lovastatin can cause liver damage. Commonly used lipid-lowering drugs such as statins, fibrates, niacin and other classes are liver toxicity. Manifested mainly in patients with asymptomatic elevated aminotransferases, some of the original with cholestatic hepatitis can occur even in patients with liver failure. Thus, simply because of high blood lipids freely purchased at pharmacies taking lipid-lowering drugs is not desirable. Lipid-lowering should be under the guidance of a doctor, is divided into drug prevention and treatment medication, strictly control the dosage, the patient every 1 to 2 months to go to the hospital once a review of liver function.
5 class medicine, where appropriate, use
Statins is currently the most commonly used clinical lipid-lowering drugs are statins such as simvastatin, pravastatin, fluvastatin, atorvastatin. Common dose: pravastatin (Pravachol, Mevalotin) oral administration of 20mg / d, undesirable effects may gradually increase the amount of the maximum dose of 40mg / d; simvastatin (Zocor) is commonly used amount of 10mg / d, maximum dose of 40mg / d; atorvastatin (Lipitor) is commonly used amount of 10mg / d, maximum dose of 80mg / d; fluvastatin (Lescol) to maintain the amount of 20mg / d, the amount used to 40mg / d, maximum dose of 80mg / d, before going to bed clothes.
Application of lipid-lowering statins, 2% ~ 3% of patients will develop gastrointestinal disorders, nausea, insomnia, muscle tenderness, and skin rashes and other side effects. About 2% of patients treated with lovastatin, showing that increased hepatic transaminases, therefore, drugs should be regularly monitored during the liver function. Some patients taking mevastatin, lovastatin and pravastatin have muscle tenderness after, as well as a transient serum creatine kinase (CK) levels increased slightly.
Fibrate lipid-lowering drugs commonly used fibrates, including fenofibrate (Fenofibrate), bezafibrate (required lipid-lowering), gemfibrozil (Connaught Heng Jie fat), these drugs mainly applicable to based on the total cholesterol in patients. The most common adverse reactions were gastrointestinal reactions, some of which may be caused by stones, gallstones or gallbladder disease and therefore banned.
Nicotinic acid class have common type of domestic and Eximosi niacin. Common side effects are red in the face, elevated aminotransferases, gastrointestinal reactions and skin itching and so on. Mainly applicable to patients with elevated total cholesterol.
Bile acid ester chelating agent commonly used drugs, including colestyramine (cholestyramine), colestipol (bile drop sheet). Common side effects of taste loss and constipation, add water with flavoring agents and multi-fiber can alleviate. At present the clinical application of these drugs are not, largely applicable to younger patients, can also be combined with statins.
Lipid-lowering Chinese medicine for hyperlipidemia and hyperlipidemia caused by atherosclerosis, fatty liver, etc., suitable for coronary heart disease and stroke prevention in patients with long-term use. Patients may be short-lived mild gastrointestinal discomfort, it is recommended after meal.
At present the treatment of dyslipidemia, there is not two kinds of over-medication and medication errors. Some patients have to come down as soon as blood lipids and multi-medication, and the other for fear of drug side effects in some patients without medication. As long as the correct approach is to detect high blood lipids (as long as above the target), it can be a doctor, under the guidance of scientific medicine, in order to prevent the occurrence of cardiovascular disease. In the lipid-lowering process, once the risk of drug-induced liver injury, it is timely or appropriate reduction dressing to prevent disease progression. LI Xing)