ABSTRACT
Thegoal of this chapter is toprovide a broadoverviewof the subject of this book and to introduce a
number of concepts that will be expanded upon in subsequent chapters. Drug-induced liver
disease represents an important problem for the following major reasons: (1) approximately 1000
drugs have been implicated in causing liver disease at least on rare occasions (1); (2) in the United
States drug-induced liver disease is the most common cause of acute liver failure, accounting for
one-third to one-half of cases (2,3); although acetaminophen accounts for the bulk of these, other
drugs are still a more frequent cause of acute liver failure than viral hepatitis and other causes (4);
(3) in addition, drug-induced liver disease represents an important diagnostic/therapeutic
challenge for physicians caring for patients presenting with liver disorders, since it can mimic
all formsof acute or chronic liver disease (5); the frequency and economic impact of this problem is
amajor challenge for the pharmaceutical industry and regulatory bodies, especially since the toxic
potential of some drugs is not evident in preclinical and phase 1 to 3 clinical testing.
