Hepatic impairment

Question 1

Patients with hepatic impairment may have:

Answer 1

Reduced ability to metabolise (toxicity and enhanced dose related side effects)
Reduced ability to synthesize plasma proteins (toxicity from high protein bound drugs)
Reduced hepatic blood flow (elevated levels of drugs subject to first pass metabolism)

Question 2

Antipsychotics in hepatic impairment

Answer 2

Recommendations. Haloperidol
Amisulpride
Sulpiride

Question 3

Antidepressants in hepatic impairment

Answer 3

Recommendations. Imipramine
Paroxetine
Citalopram

Question 4

Mood stabilisers in hepatic impairment

Answer 4

Lithium

Question 5

Sedatives in hepatic impairment

Answer 5

Recommendations. Lorazepam
Oxazepam
Temazepam
Zopliclone 3.75mg (with care)