Drug-induced Hyperbilirubinemia and the Clinical Influencing Factors

Abstract

Hyperbilirubinemia may accompany harmful effects such as jaundice, brain dysfunction, and pharmacokinetic alterations of drugs. Clinical drugs are the important causes of hyperbilirubinemia, especially for patients with certain pathologic conditions or with genetic variations. This article reviews hyperbilirubinemic pathophysiology with respect to the effects of clinical drugs. In addition, this review introduces a new formula that may be utilized to estimate the annual occurrences of drug-induced hyperbilirubinemia in a hospital. Variations in the genes of UDP-glucuronosyltransferases, organic anion-transporting polypeptides and multidrug resistance proteins are the predisposing factors for drug-induced hyperbilirubinemia; therefore, their genetic and ethnic polymorphisms are discussed.

Key Words:

• Hyperbilirubinemia
• UGT1A1
• OATP1B1
• Multidrug resistance-associated protein 2 (MRA2)
• Genetic polymorphisms
• Annual occurrence indices
• Adverse drug reactions

ACKNOWLEDGMENTS

This work was supported by a Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MEST) (No.R11-2007-107-01001-0).