Hepatic Encephalopathy Flashcards
What is hepatic encephalopathy also known as?
Portosystemic encephalopathy
What is hepatic encephalopathy due to?
A build up of toxins that affect the brain
What causes a build up of toxins resulting in hepatic encephalopathy?
Excess absorption of ammonia and glutamine from bacterial breakdown of proteins in the gut.
What is hepatic encephalopathy common associated with?
Acute liver failure
What is one of the main toxins associated with a build hepatic encephalopathy?
Ammonia
How can ammonia build up in the blood?
Functional impairment of the liver cells prevents them metabolising the ammonia into harmless waste products
What are the main presenting features of hepatic encephalopathy?
confusion, altered GCS
asterix: ‘liver flap’
constructional apraxia
triphasic slow waves on EEG
raised ammonia level
How is
What are possible precipitating factors of hepatic encephalopathy?
Constipation
Electrolyte disturbance
Infection
GI bleed
High protein diet
TIPPS
Medications (particularly sedative medications)
What can be used in teh management of hepatic encephaolpathy?
Laxatives (i.e. lactulose)
What is the function of laxatives in hepatic encephalopathy?
Promote the excretion of ammonia
What other medication can be used in the management of heoatic encephalopathy?
Antibiotics (i.e. rifaximin)
Which antibiotic is useful in the management of hepatic encephalopathy?
Rifaximin
What is the function of rifaximin?
Reduces the number of intestinal bacteria producing ammonia.
What is grade 1?
Irritability
