DRUG-INDUCED LIVER INJURY-DILI AND HILI IN CLINICAL PRACTICE

Drug-induced liver damage is still a problem for modern medicine. On the one hand, it is related tothe polyprogression found mainly in the elderly and chronically ill, and on the other hand, to thefashion for young people to use dietary supplements and herbs. The course of DILI can range froma mild, asymptomatic, reversible increase in liver parameters to severe liver failure leading tohepatic encephalopathy, multiple organ failure and death of the patient. It is one of the most commoncauses of acute liver injury, accounting for 10-50% of cases and is responsible for 30-70% of casesof acute liver failure, sometimes posing a real threat to the patient's health and life.Prevention of DILI should be based on the identification of risk factors, appropriate drug selectionand patient education, avoidance of self-medication, with periodic review of patients'pharmacotherapy. Prevention of DILI requires the cooperation of the physician, pharmacist andpatient, sometimes also the patient's family or carers. Knowing the initial clinical signs andsystematically performing control tests of liver parameters (ALT, AST, ALP, bilirubin) can reducethe risk of severe forms of drug-induced liver damage. The article outlines the aetiology, methodsof diagnosis, monitoring and treatment of DILI.