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首页> 外文期刊>Journal of the American Pharmacists Association: JAPhA >Hepatotoxicity upon using niacin to pass a drug test: A case report
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Hepatotoxicity upon using niacin to pass a drug test: A case report

机译：使用烟酸通过药物测试的肝毒性：案例报告

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ObjectivesTo report a case of hepatotoxicity when niacin was used by a patient with HIV to pass a drug test. MethodsNiacin is a soluble pyridine derivative widely used in the management of dyslipidemia. Common adverse effects include flushing, nausea, gastrointestinal discomfort, and hepatotoxicity. The use of niacin for nonmedical purposes has been increasing in prevalence in recent years, particularly in attempts to alter or mask results of urine drug tests. Although there is no scientific evidence that niacin can alter a urine drug screen result, easily retrievable information exists on the Internet touting niacin as a potential way to prevent detection of tetrahydrocannabinol (THC). The following report describes a case of hepatotoxicity in an HIV-infected adult who reported using niacin to mask THC in urine drug screen results. ResultsThe patient developed marked elevations in his liver enzymes (aspartate aminotransferase greater than 25 times the upper limit of normal and alanine aminotransferase greater than 3 times the upper limit of normal) that resolved after discontinuation of the drug. Because of the patient’s self-reported use and discontinuation of niacin, the Naranjo Adverse Drug Reaction Probability Scale demonstrated a “definite” relationship between the development of hepatotoxicity and the ingestion of over-the-counter sustained-release niacin. The patient did not develop further clinical abnormalities proposed to be secondary to niacin toxicity in previously published case reports, including glucose abnormalities, coagulopathies, metabolic acidosis, QTc prolongation, and myalgias. ConclusionHealth care providers should be aware of this nonmedical use of niacin to alter or mask a drug test, especially when discerning the cause of hepatotoxicity. In addition, pharmacists in the community setting should be aware of this use of niacin when encountering patients purchasing over-the-counter niacin, particularly in patients who may be more likely to use illicit substances.
机译：当患者用艾滋病毒通过药物测试时，Objectivesto报告烟酸用患者使用烟酸时的肝毒性。方法是一种广泛用于血脂血症管理的可溶性吡啶衍生物。常见的不利影响包括冲洗，恶心，胃肠道不适和肝毒性。近年来，使用烟酸的非医疗目的在普遍存在中，普遍存在，特别是在试图改变或掩盖尿液试验的结果。虽然没有科学证据表明烟酸可以改变尿液药物筛选结果，但易于检索的信息存在于因特网吹捧烟酸作为防止检测四氢尼酚（THC）的潜在方法。以下报告描述了在尿液中涉及使用烟酸掩盖尿液筛选结果的艾滋病毒感染成年人中的肝毒性的情况。结果患者在他的肝脏酶（天冬氨酸氨基转移酶大于正常上限的正常上限的3倍的3倍）中显着的升高（天冬氨酸氨基转移酶大于正常上限的3倍）。由于患者的自我报告的使用和烟酸停止，Naranjo不良药物反应概率规模证明了肝毒性的发育与摄入过度反释放烟酸之间的“确定”关系。患者在先前公布的病例报告中没有发展进一步提出的临床异常，其中包括患者在先前公布的病例报告中，包括葡萄糖异常，凝血性，代谢酸中毒，QTC延长和肌痛。结论Health Care提供者应该了解这种非医疗使用烟酸以改变或掩盖药物测试，尤其是在识别肝毒性的原因时。此外，社区环境中的药剂师应该意识到这种在遇到购买过于逆烟酸的患者时这种使用烟酸，特别是在可能更有可能使用非法物质的患者中。

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