Drugs and the liver

Question 1

Which medications can precipitate hepatic encephalopathy?

Answer 1

Sedatives, Diuretics and drugs that can cause constipation

Question 2

What factors can trigger hepatic encephalopathy?

Answer 2

HE can be precipitated by infection, GI bleeding, constipation, electrolyte disturbances (esp Hypokalaemia and Hyponatraemia, usually from use of diuretics), and medications like sedatives.

Question 3

Which drugs should be avoided in patients with liver disease?

Answer 3

Avoid hepatotoxic drugs.
Avoid drugs that causes Na+ retention, such as NSAIDs, Steroids and Na-containing drugs such as antacids. Can exacerbate fluid overload and ascites.
Avoid drugs that interferes with homeostasis (Warfarin and Aspirin)
Avoid sedatives, diuretics and drugs that can cause constipation. They increase risk of hepatic encephalopathy.