Drug Treatment of Patients with Liver Cirrhosis in a Tertiary Hospital in Northern Ghana: Does It Comply with Recommended Guidelines?

Mohammed, Baba Sulemana; Aidoo, Matthew

doi:10.1155/2020/9750194

Cited by 7 publications

(12 citation statements)

References 24 publications

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“…Similar findings were seen in the study conducted by Baba Sulemana Mohammed and Matthew Aidoo. 4 In pharmacotherapeutic treatment, 69 patients were majorly advised with ursodeoxycholic acid, out of which 55 (13.89%) patients showed recovery with this treatment option. With nonpharmacotherapy, 74 patients were advised with water restrictions up to 800-1000 ml, out of which 64 patients (15.15%) showed recovery with this advice.…”

Section: Discussionmentioning

confidence: 99%

A Study on Trends in the Management of Chronic Liver Disease Patients

Mishra¹,

Mahadevamma²,

Sah³

2022

Int. J. Res. Ayurveda Pharm.

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Chronic liver disease (CLD) is a progressive deterioration of liver functions. The generation of clotting factors and other proteins, the detoxification of toxic metabolic products and the excretion of bile are all liver functions. This continuous inflammation, destruction, and regeneration of liver parenchyma led to fibrosis and cirrhosis. These are leading causes of morbidity and mortality in the country, majorly attributed to excessive alcohol consumption, viral hepatitis, or non-alcoholic fatty liver disease. The study aimed to understand the recent trends in managing chronic liver disease. The liver function tests were assessed in all subjects with a history of CLD complications, and treatment was initiated. Patients were re-examined with LFTs to note the efficacy of the treatment. The study showed that CLD is more prevalent in males due to their lifestyle and social habits. The primary drug prescribed was ursodeoxycholic acid (18.7%), with the best advisable diet restrictions of water and salt (17.4%). Follow-up was conducted regarding LFTs and observed improvement with treatment. With the best management plan, liver functioning can be reverted to normal. Management of CLD and its complications is vital to maintaining hepatic function and the quality of life of patients. With a note on progress, the best non-pharmacotherapies can be advised to improve patients’ quality of life. The study provides an idea to physicians regarding the recent trends and ways of planning a therapy.

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Section: Discussionmentioning

confidence: 99%

A Study on Trends in the Management of Chronic Liver Disease Patients

Mishra¹,

Mahadevamma²,

Sah³

2022

Int. J. Res. Ayurveda Pharm.

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“…After studying a variety of literature, the authors developed an organized interviewer-administered questionnaire that was utilized for collecting data. 15 , 20 , 24 The questioner had four parts, including sociodemographic variables, clinical variables, practitioner-related variables, and medication-related variables. Patients sociodemographic characteristics and practitioners’ variables were obtained by interviewing them.…”

Section: Methodsmentioning

confidence: 99%

“… 6 , 19 Drug formulary references provide advice on which medications should be used cautiously, or not at all, in patients with cirrhosis. 20 According to reports, the estimated inpatient mortality of patients with cirrhosis in Ethiopia is high; it causes deaths and hospital admissions in approximately 31% and 12% of cirrhotic patients. 21 , 22 Since patients with cirrhosis require a complex therapy plan, it necessitates regular reviews of medication utilization.…”

Section: Introductionmentioning

confidence: 99%

The Burden of Inappropriate Prescriptions and Predictors for Hospitalized Patients with Liver Cirrhosis in Ethiopia

Zeleke,

Bazezew,

Abebe

2023

HMER

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Background Pathophysiological alterations in liver cirrhosis affect how medications are metabolized and eliminated. Therefore, when prescribing medicines for patients with cirrhosis, appropriate prescription of medication is an accepted standard of practice. Since patients with cirrhosis require a complex therapy plan, it necessitates regular reviews of medication utilization. However, no research was conducted in Ethiopia. The aim of this study was to figure out the predictors of inappropriate prescriptions and the pattern of prescription in patients with cirrhosis. Patients and methods A cross-sectional study design was carried out at Felege-Hiwot, a specialized and comprehensive referral hospital, from June 30, 2022, to November 30, 2022, in 123 hospitalized patients with cirrhosis. Patients were recruited using a simple random sampling procedure, and data were collected using an interviewer-administered questionnaire. For the purpose of identifying determinants of inappropriate prescription, logistic regression analyses have been carried out and statistical significance was defined by a p-value of less than 0.05 and a 95% confidence range. Results The burden of inappropriate prescriptions among patients with cirrhosis was 35.8%. An increased number of medications prescribed (AOR = 4.88 (1.05–22.68)), prescription by a general practitioner (AOR = 3.57 (95% CI 1.07–11.44)), increased level of bilirubin (AOR = 3.54 (95% CI 1.95–6.45)), and decreased level of albumin (AOR = 0.18 (95% CI 0.04–0.72)) were predictors for an inappropriate prescription. Conclusion It has been found that there were inappropriate prescriptions among patients with liver cirrhosis. Prescribers should pay close attention to patients who have prescribed with higher number of medications, increased level of bilirubin and decreased level of albumin. Moreover, educational level of prescribers needs to be upgraded in order to adopt evidence-based medication prescriptions and adhere to recommended practices.

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“…5 It was evident that with progressive stages of liver cirrhosis retention of unbound drug in the plasma increased which may result in the prognosis of PVT in the severe stage of liver cirrhosis (CP-C population). 60 An additional care and dose adjustment will be required in this indication to avoid this lifethreatening situation. It was also evident from the evaluation of the developed PBPK drug-disease model that clearance of propranolol is much lower in progressive stages of liver cirrhosis and plasma concentration of drug increases with the progression in severity of disease ie from CP-A to CP-C population.…”

Section: Figurementioning

confidence: 99%

Development and Evaluation of a Physiologically Based Pharmacokinetic Drug-Disease Model of Propranolol for Suggesting Model Informed Dosing in Liver Cirrhosis Patients

Kalam¹,

Rasool²,

Alqahtani³

et al. 2021

DDDT

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The study was aimed to understand the underlying causes for the differences in propranolol pharmacokinetics (PK) between healthy and cirrhosis populations by using a systematic whole-body physiologically based pharmacokinetic (PBPK) model-building approach for suggesting model informed propranolol dosing in liver cirrhosis patients with different stages of disease severity. Methods: A whole-body PBPK model was developed by using population simulator PK-Sim ® by using reported physicochemical and clinical data for propranolol in healthy and liver cirrhosis populations. The model evaluation was done by visual verification and comparison of PK parameters using their observed/predicted ratios (R obs/pred). Results: The developed model has effectively described the disposition of propranolol after intravenous and oral application in healthy and liver cirrhosis populations. All the model predictions were comparable to the observed clinical data and the R obs/pred for all the PK parameters were within a 2-fold range. A significant increase in plasma concentration of propranolol and decrease in drug clearance was observed in progressive stages of liver cirrhosis. The developed model after evaluation with the reported clinical PK data was used for suggesting model informed propranolol dosing in different stages of liver cirrhosis based on systemic unbound drug concentration. Conclusion: The developed PBPK model has successfully described propranolol PK in healthy and cirrhosis populations after IV and oral administration. The evaluated PBPK propranolol-cirrhosis model can have many implications in predicting propranolol dosing in liver cirrhosis patients with different stages of disease severity.

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Drug Treatment of Patients with Liver Cirrhosis in a Tertiary Hospital in Northern Ghana: Does It Comply with Recommended Guidelines?

Cited by 7 publications

References 24 publications

A Study on Trends in the Management of Chronic Liver Disease Patients

A Study on Trends in the Management of Chronic Liver Disease Patients

The Burden of Inappropriate Prescriptions and Predictors for Hospitalized Patients with Liver Cirrhosis in Ethiopia

Development and Evaluation of a Physiologically Based Pharmacokinetic Drug-Disease Model of Propranolol for Suggesting Model Informed Dosing in Liver Cirrhosis Patients

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