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The pharmacotherapy of cirrhosis: concerns and proposed investigations and solutions
Author(s) -
Hilscher M. B.,
Odell L. J.,
Myhre L. J.,
Prokop L.,
Talwalkar J.
Publication year - 2016
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12443
Subject(s) - cirrhosis , medicine , pharmacotherapy , medical prescription , dosing , intensive care medicine , population , drug , adverse effect , incidence (geometry) , drug reaction , pharmacology , environmental health , physics , optics
Summary What is known and objective The presence of cirrhosis has a multifaceted impact on hepatic drug metabolism. An area of concern and uncertainty in the care of patients with cirrhosis is the safe use of both prescription and over‐the‐counter medications. Comment Retrospective studies indicate a high incidence of adverse drug reactions ( ADR s) among patients with cirrhosis related to use of certain medication classes including angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers and non‐steroidal anti‐inflammatory drugs. Conversely, use of appropriate medications, such as statins, may be decreased in this population due to fear of precipitating hepatotoxicity. What is new and conclusion Pharmacotherapy in cirrhosis is an area of uncertainty and heterogeneity in clinical practice. Prescribing and dosing guidelines are needed to decrease the risk of serious ADR s in this high‐risk patient population.