DOSAGE ADJUSTMENTS OF POTENTIALLY HEPATOTOXIC MEDICATIONS IN PATIENTS WITH LIVER DYSFUNCTION
Journal Title: Hygeia:journal for drugs and medicines - Year 2016, Vol 8, Issue 1
Abstract
Plan: To assess the incidence of inappropriate dosing of drugs having side effects like hepatotoxicity in hospitalized patients with hepatic impairment. Preface: Inappropriate dosing in patients with liver dysfunction can cause toxicity or ineffective therapy. Method: The degree of hepatic impairment was calculated using Child-Pugh classification which incorporates five variables to assess the severity of liver disease: total bilirubin, serum albumin, prothrombin time, the presence of encephalopathy and the presence of ascites. The dose of all drugs with potential hepatotoxicity was evaluated using the published drug dosing guidelines and the dosing interval was increased or the total dose was reduced when necessary. Outcome: Four hundred and twenty nine drugs in 50 patients were evaluated, of which, most of the drugs requiring dose adjustment were antihypertensives followed by antidiabetics. Major type of error identified was underdosing followed by overdosing and contraindications. About 27.58% of the drugs were to be avoided in hepatic impairment as per the available evidences. Conclusion: Drug dosing evaluation and concurrent feedback mechanism by the pharmacist can improve drug safety in patients with hepatic impairment.
Authors and Affiliations
Manjula Devi A. S, Senthilvel. N, Dhanu Josey, Divya Ann Jetto, Evelyn Harold, Mabel Elizabeth V. K
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