Clinical Case Database / Category: Clinical Care

Drug treatment of liver disease

Publication details

Alastair O'Brien, Bsc, MBBS, MRCP, PhD, Professor Roger Williams, CBE, MD, FRCP, FRCS, FRCPE, FRACP, FMedSci, FRCPI (Hon), FACP (Hon)
Foundation Years Journal, volume 5, issue 8, p.20 (123Doc Education, London, September 2011)

Abstract

A 55 year old man presents to A&E feeling unwell and is found to have fast atrial fibrillation and aspiration pneumonia. Upon taking a history you find that he has a heavy history of alcohol consumption throughout his adult life. On examination you find that he is icteric, spider naevi are present and he has ascites. His blood tests show a platelet count of 105, INR 1.4, Albumin 32, bilirubin 65, ALT 40, Alk Phos 105. This article will help you decide on the most appropriate treatment, dosing regimen, monitoring and possible adverse events in the management of this patient.

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Authors

Alastair O'Brien, Bsc, MBBS, MRCP, PhD

Clinical Senior Lecturer and Honorary Consultant in Hepatology,
University College London Medical School,
University College Hospital and
The Royal Free Hospital NHS Trust
a.obrien@ucl.ac.uk

Professor Roger Williams, CBE, MD, FRCP, FRCS, FRCPE, FRACP, FMedSci, FRCPI (Hon), FACP (Hon)

Institute of Hepatology London
Foundation for Liver Research
69-75 Chenies Mews,
London WC1E 6HX
r.williams@researchinliver.org.uk

References

1. Delco, F., Tchbaz, L., Schlienger, R. Drewe, J, Krahenbuhl, S. (2005). Dose adjustment in patients with liver disease. Drug Safety; 28: 529-45.
2. Lee, W. M. (2003). Drug-Induced Hepatotoxicity, N. Engl. J. Med. 349: 474-85.
3. Lewis J.H. (2002). Expert Opinion on Drug Safety, Vol 1, No. 2, pp. 159-172(14). Informa Healthcare.
4. Pirmohamed, M. (2007). Prescribing in liver disease, Medicine 35: 1, 31-4.

Disclaimers

Conflict Of Interest

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Financial Statement

The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.

Patient Consent statement

All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.

Animal & Human Rights

When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.

About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.