Examples include carbon tetrachloride, phosphorus, chloroform, vinyl chloride, and
(1) Signs and symptoms include anorexia, nausea, vomiting, jaundice, and
Liver damage occurs within 24-48 hours, depending on the dose of the
For recovery to occur, the toxin must be identified and removed as soon
b. Drug induced hepatitis is an idiosyncratic reaction to a drug due to
hypersensitivity. Examples include sulfonamides, isoniazid, and halothane.
(1) Symptoms may appear any time during or after exposure to the drug,
but usually appear after 2-4 weeks of therapy.
(2) Onset is generally abrupt, with chills, fever, anorexia, nausea, rash, and
pruritis. Jaundice and hepatomegaly may occur later.
Symptoms subside when the offending drug is removed.
c. Nursing implications.
Care is symptomatic and supportive in nature.
(2) Patient education should be reinforced regarding proper handling of
chemicals, cleaning agents, solvents, and so forth, as applicable.
(3) Nursing personnel, pharmacists, and physicians should alert patients to
medication side effects. If fever, rash, or pruritis result from any medication, it should be
stopped at once and the prescribing physician consulted.
Patients with known liver disease should not receive halothane as an
a. Cirrhosis is a chronic disease of the liver characterized by destruction of the
parenchyma (functional) cells, with fibrotic tissue replacement. This degeneration
causes impaired blood and lymph flow, which results in hepatic insufficiency. The major
causes of cirrhosis are alcohol abuse and chronic hepatitis.
b. Cirrhosis has a long, latent period with vague gastrointestinal symptoms
including anorexia, indigestion, nausea, vomiting, constipation, and diarrhea.