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SA Pharmacy Medicines Information Service

Liver

Consider…

LFTs – INR, ALT, ALP, AST, GGT, bilirubin, albumin and pattern of change 

SIGNS AND SYMPTOMS OF LIVER DISEASE‚Äč – eg. ascites, oesophageal varices, jaundice, encephalopathy

CAUSE OF LIVER IMPAIRMENT‚Äč –  chronic (eg. alcoholic liver disease) or acute (eg. drug induced)

CREATININE – ensure no hepato-renal syndrome/renal impairment if using medications which are renally cleared

PHARMACOKINETICS – favourable characteristics in liver impairment are renal excretion, short half-life, low protein binding, no high first-pass metabolism, no active metabolites and no enterohepatic recirculation

PHARMACODYNAMICS avoid or use with caution any medications with side effects which might worsen signs/symptoms of liver disease (eg. blood thinning, oesophageal reflux, fluid retention, sedation/CNS activity, constipation, hepatotoxic) 

HEPATOTOXICITY  consider current drug causes, hold/suspend any non-essential medications which may cause severe/fatal hepatotoxicity 

Specialised Resources


 


Societal Guidelines

 

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