Week 6C Liver Disease

Question 1

chronic kidney disease

Answer 1

abnormal liver functions for more than six months

inflammation that leads to fibrosis and cirrhosis

Question 2

child pugh score

Answer 2

assess prognosis of chronic liver disease, mainly cirrhosis
– Score 5-6: class A (mild)
– Score 7-9: class B (moderate)
– Score 10-15: class C (severe)
ADD THE SCORES

Question 3

• MELD (Model for End stage Liver Disease) score

Answer 3

designed to predict 3-month mortality among

patients on a liver-transplant waiting list

Question 4

Child-Pugh score system

• System based on five variables:

Answer 4

– Presence of ascites
– Presence of encephalopathy
– Plasma concentration of bilirubin
– Plasma concentration of albumin
– Prothrombin time

Question 5

e if drug is significantly cleared by liver,

Answer 5

1) Dose adjustment based on manufacturer product information
2) Calculated dose based on popPK data in patients with CLD.
3) Theoretical adjustment recommendation of Delcò.
4) Avoid if possible

Question 6

Calculated dose based on PopPK data
in CLD patients
adjusted dose =

Answer 6

= target AUC x Clearance / F

Question 7

DELCO Eh
Category 1: High (>60%)

Category 2: intermediate (30-60%)

Category 3: Low (< or equal to 30%)

Answer 7

adjusted dose = normal dose x F%/100%

Initial dose: start in the low range of normal
Maintenance dose: should be adjusted as described in low Eh and low PB

drug monitoring
CP A: 50% of normal dose
CP B: 25% of normal dose
CP C: drug monitoring