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What Medications Commonly Given in the Acute Care Setting Are Safe in Liver Failure and Cirrhosis? In What Doses?

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Gastrointestinal Emergencies

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Abstract

No evidence-based guidelines exist for the use of medication in patients with liver cirrhosis; however based on drug pharmacokinetics, many medications require dosage adjustment. Acetaminophen can be used safely at low doses (≤2–3 g daily) for short durations and should be considered first-line treatment for pain as opioids can precipitate hepatic encephalopathy. Nonsteroidal anti-inflammatory drugs should be avoided as they predispose to renal failure and gastrointestinal bleeding in this population. Opioids and sedative medications should be avoided, and, if necessary, they should be given with reduced dosage or frequency. Cirrhotic patients may take prophylactic medications, and acute care providers should understand the potential for associated adverse effects.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Wellspan York Hospital, York, PA, USA

    Amber Ruest

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  1. Amber Ruest
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Correspondence to Amber Ruest .

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Editors and Affiliations

  1. Department of Emergency Medicine, MedStar Georgetown University Hospital, Washington, DC, USA

    Autumn Graham

  2. Department of Emergency Medicine, MedStar Georgetown University Hospital, Washington, DC, USA

    David J. Carlberg

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Ruest, A. (2019). What Medications Commonly Given in the Acute Care Setting Are Safe in Liver Failure and Cirrhosis? In What Doses?. In: Graham, A., Carlberg, D.J. (eds) Gastrointestinal Emergencies. Springer, Cham. https://doi.org/10.1007/978-3-319-98343-1_73

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  • DOI: https://doi.org/10.1007/978-3-319-98343-1_73

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98342-4

  • Online ISBN: 978-3-319-98343-1

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