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Evaluation

Scientific Assembly

Track Session

Session: Session 312

Liver or Let Die: The Best and Worst Meds for the Sick Cirrhotic

Monday, April 24, 2023
3:15 PM – 3:35 PM CST
Location: Salon FGH-3rd Floor
CE: 0.25 Credits
Abdominal/GI Pharmacology Recorded Session
Disclosure(s):
Rebecca Kreston, MD MSPH: No financial relationships to disclose
Patients with decompensated cirrhosis can present with a variety of life-threatening illnesses that require a specialized armamentarium to stabilize and treat their acute condition. Cirrhosis causes multiple downstream modifications to the anatomy and physiology of several organ systems. As a result, many of our go-to meds in the emergency room can worsen the clinical status of a sick cirrhotic whether it’s normal saline, NSAIDS, or narcotics. Many “liver emergencies” - such as hepatic encephalopathy or spontaneous bacterial peritonitis or variceal bleeds - have targeted medications that are infrequently used in the ER but are vital to turning around these patients.

Learning Objectives:

  • Determine whether using isotonic solutions or albumin are appropriate for volume resuscitation or managing an AKI in a cirrhotic patient.
  • Identify appropriate dosing for albumin whether it's for treating spontaneous bacterial peritonitis, recovery after large paracentesis, or for volume resuscitation.
  • Know when and how to initiate lactulose or rifaxamin for reversing hepatic encephalopathy.