Pharmacology

Question 1

Types of medicines that can be affected by liver disease:

Answer 1

• Constipating medicines (opioid analgesics, sedating antihistamines, antimuscarinic drugs
• Medications that cause GI ulceration (NSAIDs, aspirin, bisphosphonates
• Sedating medicines (opioid analgesics, benzodiazepines, hypnotics)
• Anticoagulants, antiplatelets and other medicines that cause bleeding (warfarin, aspirin, clopidogrel, NSAIDs)
• Medicines that can affect fluid-electrolyte balance (diuretics)
• Medicines with a high sodium content (antacids, soluble tablets e.g. soluble paracetamol, some IV preparations)
• Medicines that are nephrotoxic (NSAIDs, aminoglycosides)

Question 2

Which administration route is preferred for patients with liver disease?

Answer 2

Oral preferred
IM should be avoided in patients with liver disease and coagulopathy as they can lead to the development of a hematoma at the injection site
Topical preparations and patches may cause increased irritation to the skin in patients with liver disease
Rectal preparations - assess for presence of rectal varices and increased risk of bleeding