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Lactulose and Rifaximin for Hepatic Encephalopathy - #PHARMFAX

Writer's picture: Mark Nguyen, PharmD, BCEMPMark Nguyen, PharmD, BCEMP

I'm fascinated by alcoholic cirrhosis because of the horrible complications that are self-induced by a legal substance. One of those complications is hepatic encephalopathy.

 

I'm fascinated by alcoholic cirrhosis because of the horrible complications that are self-induced by a legal substance. One of those complications is hepatic encephalopathy.


Ammonia accumulates from a poorly functioning liver, stacks up in your blood stream, readily crosses the BBB, and oversaturates your astrocytes leading to cerebral edema. Severity of symptoms isn't corrected with serum ammonia levels, most times it doesnt take much with the eye test. We've got two treatment options.


Lactulose decreases absorption of ammonia by producing laxative effects and affects intestinal pH, trap ammonia in the stool. Riafaxamin reduce the amount of reduces ammonia-producing enteric bacteria, such as Klebsiella and Proteus sp. For more PHARMFAX for your drug bank, make sure to take the poll on my website under the Contact / Input tab.

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Not medical advice. Educational purposes only. No relationships to report. I hope you learned something new today.

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