Hepatic Impairment

Question 1

What are the hepatotoxic drugs?

Answer 1

Antipsychotics 
Amiodarone
Carbamazepine 
Co-amoxiclav
Dantrolene
Fluconazole
Isoniazid
Ketoconazole 
Labetalol 
Methotrexate 
Paracetamol 
Phenothiazine
Rifampicin
Statin
Tetracyclines 
Valproate

Question 2

What are the signs of liver toxicity?

Answer 2

Jaundice
Upper right abdominal pain
Nausea and vomiting
Malaise
Weight loss
Pruritis
Dark urine
Pale coloured stool
Drowsiness
Raised liver enzymes

Question 3

What drugs can precipitate hepatic coma in hepatic encephalopathy?

Answer 3

Constipating drugs
Sedating drugs
Drugs that cause hypokalaemia

Question 4

How do you treat hepatic encephalopathy?

Answer 4

Lactulose

Question 5

What drugs exacerbate oedema and ascites in liver disease?

Answer 5

Drugs that cause fluid retention
NSAIDS
Corticosteroids

Question 6

What are the enzyme inhibitors?

Answer 6

Sickfaces.com

Sodium valproate 
Isoniazid
Cimetidine
Ketoconazole 
Fluconazole
Alcohol - binge
Chloramphenicol 
Erythromycin 
Sulfonamide
Ciprofloxacin 
Omeprazole
Metronidazole

Question 7

What are the enzyme inducers?

Answer 7

CRAP GPS love BS

Carbamazepine
Rifampicin
Alcohol - chronic
Phenytoin

Griseofulvin
Phenobarbital
Sulfonylureas

Barbiturates
St Johns Wort

Question 8

What drugs are affected by grapefruit juice?

Answer 8

Amiodarone, dronedarone, ranolazine, statins, verapamil, dihydropyridine CCBs

Quetiapine, sertraline

Tacrolimus
Ciclosporin

Colchicine, phosphodiesterase type 5 inhibitors

Question 9

What are the lab results in liver impairment

Answer 9

High - ALT, AST, ALP, GGT, Bilirubin, Prothrombin time

Low - albumin