Liver disease pregnancy

Neonates and infants Renal disease Liver disease PREGNANCY... 

Contraindications Hypersensitivity to any component of these medications Active liver disease Pregnancy and lactation (Pregnancy Category X) ... 

Physiological or pathological conditions that are known to affect the kinetics of the drug (e.g. renal or liver disease, pregnancy)... 

Respiration depression, severe liver disease, pregnancy (fetal immaturity), nephrosis Nausea, vomiting, diarrhea, lethargy, drowsiness, hangover, dizziness, rash Drug dependence or tolerance, urticaria (hives), hypotension if given rapidly IV Respiratory distress, laryngospasm... 

This can be found in liver disease, pregnancy or as a result of excessive intravenous fluid infusion. 

Loop diuretics are used cautiously in patients with renal dysfunction. The loop diuretics are Pregnancy Category B (ethacrynic acid and torsemide) and C drugp (furosemide and bumetanide) and must be used cautiously during pregnancy and lactation. Furosemide is used in children but should be used cautiously. The loop diuretics are used cautiously in patients with liver disease, diabetes, lupus erythematosus (may exacerbate or activate the disease), or diarrhea. Patients with... 

There is very little evidence relating to the role of ROMs in cholestatic liver disease. Serum selenium and glutathione peroxidase activity are decreased in humans with intrahepatic cholestasis of pregnancy (Kauppila et al., 1987). Low levels of vitamin E have been reported in patients with primary biliary cirrhosis, and in children with Alagille s syndrome or biliary atresia (Knight et al., 1986 Jeffrey etal., 1987 Lemonnier etal., 1987 Babin etal., 1988 Kaplan et al., 1988 Sokol etal., 1989). Serum levels of Mn-SOD are increased in patients with all stages of primary biliary cirrhosis compared with patients with other forms of chronic liver disease, although whether this causes or results from the disease process is unclear (Ono etal., 1991). 

Digoxin-like immunore active substances (found in patients with chronic heart failure, end stage renal disease, liver disease, or third trimester of pregnancy) may cross-react with certain digoxin immunoassays and may result in a false elevation of levels... 

HRT should not be prescribed to women with a history of or active thromboembolic disease, breast cancer or estrogen-dependent neoplasm, pregnancy, liver disease, or undiagnosed vaginal bleeding. It also should not be used for the prevention or treatment of cardiovascular disease, cerebrovascular disease, or dementia.11... 

Fatty liver of pregnancy Placental abruption Preeclampsia/eclampsia Retained fetus syndrome Pulmonary syndrome syndrome Empyema Hyaline membrane disease... 

The drug may cause liver toxicity and is contraindicated in patients with preexisting liver disease. The ALT should be monitored monthly initially and periodically thereafter. Leflunomide may cause bone marrow toxicity a complete blood cell count with platelets is recommended monthly for 6 months and then every 6 to 8 weeks thereafter. It is teratogenic and should be avoided during pregnancy. 

Absolute contraindications to warfarin include active bleeding, hemorrhagic tendencies, pregnancy, and a history of warfarin-induced skin necrosis. It should be used with great caution in patients with a history of GI bleeding, recent neurosurgery, alcoholic liver disease, severe renal... 

Methotrexate, an antimetabolite, is indicated for moderate to severe psoriasis. It is particularly beneficial for psoriatic arthritis. It is also indicated for patients refractory to topical or UV therapy. Methotrexate can be administered orally, subcutaneously, or intramuscularly. The starting dose is 7.5 to 15 mg per week, increased incrementally by 2.5 mg every 2 to 4 weeks until response maximal doses are approximately 25 mg/wk. Adverse effects include nausea, vomiting, mucosal ulceration, stomatitis, malaise, headache, macrocytic anemia, and hepatic and pulmonary toxicity. Nausea and macrocytic anemia can be ameliorated by giving oral folic acid 1 to 5 mg/day. Methotrexate should be avoided in patients with active infections and in those with liver disease. It is contraindicated in pregnancy because it is teratogenic. 

Therapy with INH results in a transient elevation in serum transaminases in 12% to 15% of patients and usually occurs within the first 8 to 12 weeks of therapy. Risk factors for hepatotoxicity include patient age, preexisting liver disease, and pregnancy or postpartum state. INH also may result in neurotoxicity, most frequently presenting as peripheral neuropathy or, in overdose, seizures, and coma. Patients with pyridoxine deficiency, such as alcoholics, children, and the malnourished, are at increased risk, as are patients who are slow acetylators of INH and those predisposed to neuropathy, such as those with diabetes. 

AED pharmacokinetic data are summarized in Table 52-3. For populations known to have altered plasma protein binding, free rather than total serum concentrations should be measured if the AED is highly protein bound. Conditions altering AED protein binding include chronic renal failure, liver disease, hypoalbuminemia, burns, pregnancy, malnutrition, displac-... 

Active thrombophlebitis or thromboembolic disorders undiagnosed abnormal genital bleeding known or suspected pregnancy acute liver disease benign or malignant... 

Hypersensitivity to any component of these products active liver disease or unexplained persistent elevated liver function tests pregnancy lactation. 

Renal/Hepatic function impairment In patients with renal impairment (Ccr 50 mL/min or less) or chronic or active liver disease, the use of terbinafine is not recommended Pregnancy Category B. 

A minor asymptomatic increase in liver aminotransferase is seen in 10 to 20% of patients, whereas fatal hepatitis is seen in fewer than 1% of isoniazid recipients. Risk factors for hepatitis include underlying liver disease, advanced age, pregnancy, and combination therapy with acetaminophen. Early recognition and prompt discontinuation of the drug is recommended to prevent further damage to the liver. 

Adverse effects include anorexia, nausea, vomiting, diarrhoea and/or constipation, weight gain, skin rash hair loss, neutropenia, tremors and ataxia are occasionally reported. Valproic acid is contraindicated in liver disease, especially cirrhosis, pregnancy and hypersensitivity. 

On the other hand, primary respiratory alkalosis occurs as a result of alveolar hyperventilation. This condition is associated with a number of pulmonary diseases, bui also may appear during pregnancy, liver disease, and salicylate intoxication, among others. The sequence of events proceeds along these lines (I) Ventilation removes CO faster than the gas is produced by metabolism, causing a decrease tn pCO in the blood and body fluids, including a reduction of venous pCO . This reduces the gradient... 

Post-coital contraception should not be used when there are absolute contraindications to estrogen these include pregnancy, unstable angina, transient ischemic attacks, liver disease, undiagnosed genital bleeding, or a history of thromboembolism. Some absolute contraindications to long-term use, such as breast cancer and arterial disease, are not contraindications to short-term use (22). 

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