Prescribing in hepatic impairment 0.0 / 5 ? MedicineTherapeuticsUniversityAll boards Created by: zCreated on: 22-02-16 21:37 Hepatic impairment only occurs in sever disease as hepatic reserve islarge PT does NOT reflect metabolic capacity (only synthetic function) reduced function can results in: hypoproteinaemia- reduced protein binding complicates interpretation of phenytoin plasma conc b/c incr free drug reduced clotting- incr sensitivity to warfarin, NSAIDs fluid overload (thus avoid drugs which exacerbate e.g. NSAIDs, corticosteroids) biliary obstruction prevents excretion of some drugs (e.g. rifampicin) and action of others (e.g. colestyramine) avoid drugs that precipitate hepatic encephalopathy sedatives, diuretics (via hypokalaemia), constipators (opiates) 1 of 1
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