Prescribing in liver disease

Question 1

What does cirrhosis of the liver cause?

Answer 1

Reduced metabolic capacity
Portal hypertension
High portal pressure and low albumin = ascites
Shunting of blood by-passing the liver

Question 2

What are the 3 major factors in cirrhosis in terms of what it reduces?

Answer 2

Reduced liver blood flow
Reduced metabolic function
Reduced plasma proteins

Question 3

What are the consequences for the kidney due to cirrhosis of the liver?

Answer 3

Potassium loss
Sodium retention
Water retention

Question 4

What might moderate hepatic impairment lead to?

Answer 4

Decreased renal clearance
Effect on unbound drugs masked by decreased protein binding
Renal function reduced