| How to manage medications in the setting of liver disease with the application of six questions. | |
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MedLine Citation:
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PMID: 20584219 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: Reviewing the current literature to guide clinicians managing medications in the setting of liver disease. LITERATURE SOURCES: Using the terms liver disease, medication management, and therapeutic monitoring, a literature review was conducted to identify peer-reviewed articles in MEDLINE (1966-April 2009). Reference citations were reviewed as an additional resource. Published English-language literatures, articles and trials were reviewed. Emphasis was placed on prospective, randomised, double-blind, placebo-controlled clinical trials. QUESTION SYNTHESIS: An informed decision on how to manage medications in the setting of liver disease should account for changes that transpire in a medication's first-pass metabolism, protein binding, volume of distribution, clearance and pharmacodynamic interactions. To incorporate these issues within one's thought process, clinicians can utilise the following six questions to evaluate a medication use: (i) Is the patient experiencing acute or chronic liver failure? (ii) Does the drug have high hepatic first-pass metabolism? (iii) Is the medication highly protein-bound? (iv) Is there a change in the volume of distribution for the medication? (v) Is the clearance of the medication significantly altered? and (vi) Is there a pharmacodynamic interaction with the medication? CONCLUSIONS: The introduction and use of six clinically relevant questions in the setting of liver disease can serve as a guide to clinicians who manage patients with liver disease. |
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Authors:
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H M Nguyen; A J Cutie; D Q Pham |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of clinical practice Volume: 64 ISSN: 1742-1241 ISO Abbreviation: Int. J. Clin. Pract. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9712381 Medline TA: Int J Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 858-67 Citation Subset: IM |
Affiliation:
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Pharmacy Practice, Western University of Health Sciences, College of Pharmacy, Pomona, CA 91766-1854, USA. mnguyen3@westernu.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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