Acta Pharmacologica Sinica 2006 March; 27 (3): 259-272; doi: 10.1111/j.1745-7254.2006.00278.x

With the increasing incidence of drug-induced liver disease, attempts are being made to better understand the mechanisms behind these frequently life-endangering reactions. Analgesics and anti-inflammatory drugs are a major group exhibiting hepatotoxicity. We review research relating to these reactions, focusing on ultrastructural findings, which may contribute to the comprehension and possible avoidance of drug-induced liver disease. We also present some original observations on clinical material and cultured cells exposed to acetaminophen alone or in combination with the antioxidant N-acetylcysteine or the P-glycoprotein inhibitor verapamil.

Keywords: non-steroidal anti-inflammatory agents; drug toxicity; liver; aspirin; acetaminophen; cultured cells; electron microscopy; apopto-sis; P-glycoprotein; acetylcysteine