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Prescribing for a first episode of affective psychosis
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
Gastrointestinal symptoms, weight gain and hair loss are none the less common causes of treatment discontinuation.205 If dyspepsia is troublesome, ranitidine may help. Serum amylase should be measured in any patient who presents with acute abdominal pain. Hair loss is usually transient; some reports suggest that vitamins with trace minerals reduce this problem.205 Regrowth may be curly. Although raised liver enzymes are not uncommon, because of the occurrence of hepatic failure, patients with raised liver function tests (LFTs) should be assessed clinically, and monitored until the LFTs return to normal. If the raised LFTs are associated with a prolongation of the prothrombin time and other signs of impending hepatic failure, valproate should be discontinued.249
The patient with acute gastrointestinal problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Rebecca Maindonald, Adrian Jugdoyal
The patient in liver failure will also have abnormal blood results that detect deterioration in liver function. These have previously been referred to as liver function tests (LFTs), but as LFTs include elevations of hepatobiliary liver enzymes that indicate ongoing injury rather than functional changes, the term ‘abnormal liver blood test’ is now used (Newsome et al. 2017). These are summarised below: Indicators of abnormal function: abnormal clotting (e.g., prolonged PT or increased INR). Clotting factors are synthesised in the liver and there is a reduction in circulating clotting factors with the degree of prolongation of PT being used as a prognosticator. Serial tests need to be analysed with platelets and FFP being administered only if bleeding actively.Assessment of damage: liver enzymes are raised. These exist normally within liver cells, but will leak into the plasma when damaged (e.g., AST, Aspartate transaminase and ALT, Alanine aminotransferase [most specific for liver damage]).Excretory capacity: bilirubin is increased in obstruction (direct/conjugated) or erythrocyte breakdown (indirect/unconjugated). At a level above 50 umol/L, jaundice will be apparent.
Investigating the hepatoprotective potential of Ocimum americanum L. ethanol extract in rifampicin-induced hepatotoxicity mice
Published in Ade Gafar Abdullah, Isma Widiaty, Cep Ubad Abdullah, Medical Technology and Environmental Health, 2020
D. Renovaldi, E. Multazam, Y. Safitri
ALT is the biomarker that is most often relied upon to detect hepatoxicity. This is a liver enzyme that plays an important role in amino acid metabolism and gluconeogenesis. It catalyzes the reductive transfer of amino groups from alanine to α-ketoglutarate to produce glutamate and pyruvate. The normal level of this enzyme is in the range of 5-50 U/L. Increased levels of this enzyme are released in circulation during damages to liver cells. In other hands, AST is another liver enzyme that helps in producing/forming proteins. This enzyme catalyzes the reductive transfer of amino groups from aspartate to α-ketoglutarate to produce oxaloacetate and glutamate. In addition to the liver, AST is also found in other organs such as the heart, muscles, and kidneys. Injury to these tissues can cause an increase in AST levels in the blood. Normal levels in the range of 7-40 U/L. AST also helps in detecting hepatocellular necrosis but it is considered as a biomarker enzyme that is less specific for hepatocellular injury because it can also indicate abnormalities in the heart, muscles, brain or kidneys (Pandit et al. 2012, Singh et al. 2011)
Ameliorative role of metformin on lipopolysaccharide-mediated liver malfunction through suppression of inflammation and oxidative stress in rats
Published in Toxin Reviews, 2022
Farimah Beheshti, Mahmoud Hosseini, Zohreh Arab, Amir Asghari, Akbar Anaeigoudari
The liver has been demonstrated to be strongly vulnerable to damage caused by toxins (Ullah et al.2016). This subject is attributed to the role of this vital organ in neutralizing the toxins which enter the body (Edenta et al.2017). ALK-P is a membrane-linked enzyme that regulates the permeability and transportation of liver cells membrane (Nakano et al.2007). ALT and AST are principal liver enzymes that metabolize amino acids (Edenta et al.2017). It has been shown that hepatotoxicity-caused cell membrane destruction leads to the entrance of these biomarkers into circulation (Beheshti et al.2019). In our study, LPS disturbed normal liver function in rats and elevated the blood content of these enzymes. As indicated in Figure1, the serum level of all three enzymes was higher in the LPS group when compared to the control group. Our results also exhibited a considerable decrease in serum concentration of total protein and albumin in rats exposed by LPS vis-à-vis those of treated by saline. This finding supports by previous studies that pointed out that liver dysfunction can be followed by a severe reduction in the generation of proteins by hepatocytes (Beheshti et al.2018).
The association of von willebrand factor and its cleaving protease (ADAMTS13) with health behaviours in young black and white adults: the African-PREDICT study
Published in Biomarkers, 2021
Nonkululeko Hellen Navise, Leandi Lammertyn, Gontse G Mokwatsi, Aletta E Schutte
Interestingly, we found a potential beneficial positive relationship between ADAMTS13 and GGT. The liver enzyme, GGT is strongly and consistently associated with the metabolic syndrome, stroke and other CVD (Lee et al.2007, Yang et al.2018). Our finding is thus unexpected and not corroborated by previous reports where an inverse association between ADAMTS13 and GGT were reported in 432 men and woman, of mean age 54.8 and 56.4 years, respectively (Enooku et al.2013). We originally regarded GGT as a marker of alcohol consumption. However, as GGT is also an alternative marker of oxidative stress (Torino et al.2016) and NAFLD (Banderas et al.2012), we performed sensitivity analyses by substituting GGT with self-reported alcohol use (no/yes). The relationship between ADAMTS13 and self-reported alcohol consumption was not significant, suggesting that GGT likely represented other conditions such as oxidative stress. The finding is challenging to interpret as self-reported alcohol intake may also be unreliable as people tend to under-report their drinking behaviour. It remains unclear why elevated GGT would associate with increased ADAMTS13 levels.
Severe drug-induced liver injury in patients under treatment with antipsychotic drugs: Data from the AMSP study
Published in The World Journal of Biological Psychiatry, 2021
Katrin Druschky, Sermin Toto, Stefan Bleich, Jessica Baumgärtner, Rolf R. Engel, Renate Grohmann, Hannah B. Maier, Alexandra Neyazi, Yannick J. Rudolph, Eckart Rüther, Harald Schwörer, Johanna Seifert, Susanne Stübner, Detlef Degner
In 47 of 246 DILI cases (19.1%), transaminases and/or GGT levels reached maximum values of 500–1000 U/l. In 13 cases (5.3%), liver enzymes reached levels above 1000 U/l. Clinical symptoms were present in 8 of the 47 cases of liver enzyme elevations of 500–1000 U/l and in 4 of the 13 cases of elevations of >1000 U/l. They included fatigue in seven cases, nausea and vomiting in three cases, and epigastric pain in five cases. The following individual APDs were imputed for the 13 cases of liver enzyme elevations of >1000 U/l: quetiapine (3 cases, 'imputed alone'), olanzapine (3 cases: 1 case 'imputed alone', 2 cases 'imputed in combination with antidepressants'), clozapine (3 cases: 1 case 'imputed alone', 2 cases 'imputed in combination with antidepressants'), amisulpride (1 case, 'imputed alone'), perazine (1 case, 'imputed alone'), promethazine (1 case, 'imputed in combination with antidepressant') and risperidone (1 case, 'imputed in combination with antidepressant').