Advances in Drug Therapy and Medication Safety in Liver Cirrhosis: A Pharmacological Review

Author

Soni Nancyben Samirbhai,Dr. Harsha Patel , Mrs. Manuni Thakkar , Vaidehi Trivedi, Aryan Vasani , Vishakha Thakkar , Srushti Vataliya

Abstract

 Aim: This review looks at recent progress in drug therapy and medication safety in liver cirrhosis. It covers treatment of the underlying cause, portal pressure control, drug therapy for specific complications, and high-risk medicines needing dose adjustment or deprescribing. Methods: A narrative review of 30 key sources published between 2006 and 2024 (AASLD and EASL guidelines, consensus statements, randomized trials, a meta-analysis and observational studies) was carried out and summarised descriptively. Results: Chronic liver disease and cirrhosis cause more than 1.3 million deaths each year, and after decompensation estimated 5-year survival drops from over 80–90% to under 50% [1,3]. Pangenotypic direct-acting antivirals cure over 95% of hepatitis C patients [2], and carvedilol has largely replaced older non-selective beta-blockers for portal hypertension [6,9]. Ascites, hepatic encephalopathy and hepatorenal syndrome are treated with spironolactone plus furosemide, lactulose plus rifaximin, and terlipressin plus albumin, respectively. Because the diseased liver handles drugs differently, NSAIDs, opioids, sedatives and unneeded proton pump inhibitors are the main high-risk drugs [25–29]. Conclusion: Good care combines disease-directed pharmacotherapy with dose adjustment, deliberate deprescribing and regular medication-safety monitoring, with clinical pharmacists playing a key part.

Keywords

Liver cirrhosis, portal hypertension, carvedilol, direct-acting antivirals, hepatic encephalopathy, medication safety, deprescribing, clinical pharmacist

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References

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