Search

Objective: To analyze the characteristics of hepatotoxicity due to ticlopidine., Patients and Methods: We describe all the case of hepatotoxicity attributed to ticlopidine and reported to the Register of drug associated hepatopathies. We also obtained data from MEDLINE and the Spanish Medical Index regarding cases reported during the period 1982 2001., Results: We reported twelve cases of hepatopathy related to the use of ticlopidine. These made up 5% of all the cases notified to the Register. Eighty three percent of the patients were male, and of an average age of 68 years. Sixty six percent required hospital admission. The latent period varied between 2 and 13 weeks. The liver lesion was of cholestatic type in 75% of the cases, hepatocellular in 16.6% and mixed in 8.3%. Twenty five percent of the patients had received sub therapeutic doses., Conclusions: Ticlopidine is often related to hepatotoxicity. This seems to be due to an idiosyncratic mechanism and is mainly cholestatic. The use of lower dosage than that recommended means that the desired therapeutic effect is not attained but does not protect against the development of hepatotoxicity. Doctors who use this drug should be aware of this so as to establish the true risk benefit relation.

Identification of so called endothelium derived relaxing factor, EDRF, as nitric oxide, ON, produced in situ in digestive tract, as well as in many other organs, offers the possibility of pharmacologic control blocking or stimulating its production in situ. Theoretically, conditions like achalasia, cell injury by endotoxins, altered visceral arterial flow, hyperdynamic circulatory state in decompensated cirrhosis, protein synthesis and glomerular filtration in ascites, will be amenable of better treatment. This gas is considered as labile humoral-like messenger, mediator or a regulator of cell function in a number of physiological are promising. By now most of the information available comes from animal studies.