IBUPROFEN
WARNING
Dr.
Thomas Riley III, the medical director for the liver transplant program at the
Milton S. Hershey Medical Center at the Penn State Geinsinger Health System
ways that patients with chronic hepatitis C experience a 10-fold rise in their
enzymes after taking ibuprofen, suggesting significant liver injury.
He
added that if too much medication is taken the patient risks speeding up the
process of going from chronic hepatitis to cirrhosis of the liver.
Dr.
Riley has an article in the September issue of the American Journal of
Gastroenterology.
IBUPROFEN-INDUCED
HEPATOTOXICITY IN PATIENTS WITH CHRONIC HEPATITIS C
Hepatitis
C is a common chronic infection. Nonsteroidal anti-inflammatory drugs are
commonly ingested both over-the-counter and by prescription. This case report
describes three cases where ibuprofen use leads to a marked rise in hepatitic
transaminases with one case repeating on rechallenge. These cases support the
recommendation of acetaminophen over Nonsteroidal anti-inflammatory drug use in
patients with chronic hepatitis C. AUTHOR: Riley TR 3rd, Smith JP, Penn State
Geisinger Health System, The Milton S. Hershey Medical Center, The Pennsylvania
State University, Department of Medicine, Hershey 17033-0850, USA SOURCE: Am J
Gastroenterol 1998 Sep; 93(9) 1563-1565
PREVENTIVE
CARE IN CHRONIC LIVER DISEASE
J
Gen Intern Med 1999 Nov, 14 (11): 699-704 Preventive Care in Chronic Liver
Disease Riley TR, Smith JP
Objective:
To identify preventive care measures that are appropriate for and specific to
patients with chronic liver disease and to provide recommendations and
information that can be shared with patients. Measurements: A review of the
literature was undertaken using MEDLINE from 1970 to present. Priority was
given to randomized controlled studies, but case reports, case-control studies,
and reviews were included. Main Results: Evidence for the avoidance of alcohol
and other toxic substances, immunizations, and dietary modifications for
chronic liver disease is summarized. In addition, measures that are effective
in the mitigation of the complications of cirrhosis are reviewed. Conclusions:
Preventive care can play an important role in patients with chronic liver
diseases. Based on the existing date, the preventive strategies of Alcohol avoidance,
Hepatitis vaccination, Avoidance of NSAIDs (nonsteroidal anti-inflammatory
drugs), iron supplementation when appropriate, and a low-fat diet are prudent
in patients with chronic liver disease. Once cirrhosis develops, screening for
hepatocellular cancer with alpha-fetoprotein testing and ultrasound, and
screening for varices by endoscopy are justified.
PMID:
10571719