[Damage to liver and biliary tracts by long-term drug therapy (author's transl)]

Drug damage to the liver can be divided into two types: Type I damage is predictable, dose-dependent and appears in most patients treated. Type II lesions are not predictable, are not dose-dependent and occur in only a small percentage of patients. Clinically they can be differentiated into (1) a cytotoxic form (clinical picture: fatty liver, virus hepatitis), (2) a cholestatic form (clinical picture: obstructive jaundice) and (3) a mixed form. In the present study, liver damage due to the following drugs, as important examples of the different types of damage, are dealt with in greater detail: isoniazid (unpredictable damage of the cytotoxic type), methotrexate (predictable damage of the cytotoxic type) chlorpromazine (unpredictable damage of the cholestatic type) and finally estrogens or oral contraceptives (damage of the cholestatic type and other damage to the hepatobiliary system).