Hygeia journal for drugs and medicines


Dosage Adjustments of Potentially Hepatotoxic Medications in Patients with Liver dysfunction

Hygeia.J.D.Med.8(1) May 2016 - October 2016  


Manjula Devi A.S*, Senthilvel. N, Dhanu Josey, Divya Ann Jetto, Evelyn Harold, Mabel Elizabeth V.K.

College of Pharmacy, SRIPMS, Sri Ramakrishna Hospital Campus, Coimbatore, 
Tamil Nadu,India-641044.

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 anti hypertensives followed by anti diabetics. Major type of error identified was under dosing 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.

Keywords : Hepatic impairment, Child- Pugh Score, Dosage adjustment, Drug safety

Corresponding author email: hari1509@gmail.com

Researcher id: C-4213-2012

Article citation 

Manjula Devi A.S*, Senthilvel. N, Dhanu Josey, Divya Ann Jetto, Evelyn Harold, Mabel Elizabeth V.K .Dosage adjustments of potentially hepatotoxic medications in patients with liver dysfunction. Hygeia.J.D.Med 2016; 8(1):16-26. Available from http://www.hygeiajournal.com / Article ID-Hygeia.J.D.Med/153/16.


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