Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/15205
Drug dosage recommendations in patients with chronic liver disease
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CitationPerianez Parraga L, Martinez-Lopez I, Ventayol Bosch P, Puigventos Latorre F, Delgado Sanchez O. Drug dosage recommendations in patients with chronic liver disease. Rev Esp Enferm Dig. 2012 Apr;104(4):165-84.
Chronic liver diseases (CLD) alter the kinetics of drugs. Despite dosage adjustment is based on Child-Pugh scores, there are no available recommendations and/or algorithms of reference to facilitate dosage regimens. A literature review about dose adjustment of the drugs from the hospital guide which are included in the list of the WHO recommended drugs to be avoided or used with caution in patients with liver disease was carried out. The therapeutic novelties from the last few years were also included. In order to do so, the summary of product characteristics (SPC), the database DrugDex-Micromedex, the WHO recommendations and the review articles from the last 10 years in Medline were reviewed. Moreover, the kinetic parameters of each drug were calculated with the aim of establishing a theoretical recommendation based on the proposal of Delco and Huet. Recommendations for 186 drugs are presented according to the SPC (49.5%), DrugDex-Micromedex (26.3%) and WHO (18.8%) indications; six recommendations were based on specific publications; the theoretical recommendation based on pharmacokinetic parameters was proposed in four drugs. The final recommendations for clinical management were: dosage modification (26.9%), hepatic/analytical monitoring of the patient (8.6%), contraindication (18.8%), use with caution (19.3%) and no adjustment required (26.3%). In this review, specific recommendations for the practical management of patients with chronic liver disease are presented. It has been elaborated through a synthesis of the published bibliography and completed by following a theoretical methodology.
Dose-Response Relationship, Drug
Drug Dosage Calculations
DeCSCálculo de Dosificación de Drogas
Relación Dosis-Respuesta a Droga