Pharmacodynamic Changes In Liver Disease

Patients with severe liver disease characteristically show abnormal end-organ response to drugs. For example:

• CNS sensitivity to opioids, sedatives and antiepilepsy drugs is increased.

• The effect of oral anticoagulants is increased because synthesis of coagulation factors is impaired.

• Fluid and electrolyte balance are altered. Sodium retention may be more readily induced by NSAIDs or corticosteroids; ascites and oedema become more resistant to diuretics.

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