[Safe prescribing in patients with liver cirrhosis; 5 pitfalls]. / Veilig voorschrijven bij levercirrose: 5 misvattingen.
Ned Tijdschr Geneeskd
; 1642020 10 29.
Article
em Nl
| MEDLINE
| ID: mdl-33201633
ABSTRACT
The liver has a major role in the pharmacokinetics and pharmacodynamics of medicines and hepatic impairment could therefore lead to increased plasma levels and adverse drug reactions. Due to the large overcapacity of the liver, medication adjustments are only needed when a chronic liver disease has progressed to cirrhosis. Important pharmacokinetic alterations that could occur in cirrhosis are (a) a decreased first-pass effect, (b) impaired metabolism by liver enzymes, and (c) in an advanced stage also impairment of renal elimination. Patients with cirrhosis could also be more sensitive to certain adverse drug reactions at normal drug levels, such as renal impairment due to NSAIDs or the sedative effect of morphinomimetics and psychotropic drugs. Prescribing in patients with cirrhosis is complex, which we illustrate by 5 common pitfalls. In practice, healthcare professionals could use a website with guidance for prescribing almost 300 medicines (www.geneesmiddelenbijlevercirrose.nl).
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Base de dados:
MEDLINE
Assunto principal:
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
/
Prescrição Inadequada
/
Fígado
/
Cirrose Hepática
/
Hepatopatias
Tipo de estudo:
Etiology_studies
/
Guideline
Limite:
Humans
Idioma:
Nl
Ano de publicação:
2020
Tipo de documento:
Article