Palliation and liver failure: palliative medications dosage guidelines

• Published in: Journal of palliative medicine Vol. 10; no. 3; p. 677
• Main Authors: Rhee, Charles, Broadbent, Andrew Mark
• Format: Journal Article
• Language: English
• Published: United States 01.06.2007
• Subjects: Guidelines as Topic; Humans; Liver Failure - drug therapy; New South Wales; Palliative Care; New South Wales
• ISSN: 1096-6218
• DOI: 10.1089/jpm.2006.0246

Palliation of symptoms is important in a variety of conditions, both malignant and nonmalignant. These symptoms may be present in patients with chronic or acute liver failure. However, to date there is a notable lack of reliable information on the use of medications that are commonly required in the palliative care of these patients. To facilitate care, a literature review was conducted with extensive searches of MEDLINE and Micromedex as well as reviews of the major textbooks of pharmacology, palliative care, gastroenterology and hepatology. A table is presented that includes medications organized in groupings of functional importance in palliative medicine such as opioids, antiarrhythmics, antidepressants, aperients, and other medications as selected for use at a Sydney palliative care unit. Data have been collected on the pharmacologic half-life in normal liver function and in cirrhosis. The latter, where suitable data could be obtained, were divided into three subgroups, using the Child-Pugh criteria. The further development of this information may help limit difficulties in choice of medication and reduce potential complications and improve palliation.