Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Etomidate is a useful addition to the list of available anesthetic agents. When faced with an animal with cardiovascular instability, cirrhosis, an intracranial lesion, susceptibility to malignant hyperthermia, anaphylactoid tendencies, or one that requires cesarean section, one should consider using etomidate. In addition, it provides a safe method for total intravenous anesthesia in situations in which the nature of the surgery precludes the use of an endotracheal tube, when the use of an inhalant is undesirable for any reason, or when inhalant anesthetic equipment is unavailable.
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PMID:Advantages of etomidate use as an anesthetic agent. 158 53

Dantrolene is the drug of choice in treatment of malignant hyperthermia. However, dantrolene is hepatotoxic; thus prolonged use is not recommended in patients with active hepatic disease such as acute hepatitis or active cirrhosis because it may result in fatal hepatic failure. Use of dantrolene in a patient with end-stage liver disease undergoing liver transplantation (LTx) in whom suspected malignant hyperthermia developed has been reported rarely. Its effect on the liver allograft, which has sustained cold, warm, and reperfusion injuries, is currently unknown. We report a case in which low-dose dantrolene administered intravenously during LTx was effective in treating hyperthermia, hypercapnia, and hyperkalemia. Furthermore, its reported hepatotoxic effect seemed to not affect recovery of the allograft after LTx.
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PMID:Low-dose dantrolene is effective in treating hyperthermia and hypercapnia, and seems not to affect recovery of the allograft after liver transplantation: case report. 2043 Jan 90

Treatment of hepatitis C virus (HCV)-infected patients with cirrhosis remains challenging. Biopsy to stage liver fibrosis remains the standard for identifying cirrhosis, although the noninvasive technique of transient elastography is promising in this regard. Cirrhosis is categorized as compensated or decompensated, with the latter characterized by ascites, hepatic hydrothorax, bleeding varices, hepatic encephalopathy, and hepatorenal syndrome. In the interferon alfa treatment era, patients with compensated cirrhosis have been candidates for interferon alfa-based treatment, whereas those with decompensated cirrhosis have been treated with caution and only at a tertiary care or transplant center. New interferon alfa-free regimens offer safer treatment alternatives to patients with cirrhosis. Response to interferon alfa-based therapy alone and in combination with the first-generation HCV protease inhibitors boceprevir or telaprevir for the treatment of HCV genotype 1 infection has been poorer in patients with cirrhosis than in those without. With regimens that include newer direct-acting antivirals, response rates are tremendously improved for patients with cirrhosis but still slightly lower than those for patients without cirrhosis. As new regimens enter use outside of clinical trials, optimizing efficacy for patients with cirrhosis will be an important goal. Patients with cirrhosis must be taught to practice liver wellness following HCV cure, to lower the risk of progression of their liver disease. Risk of hepatocellular carcinoma also persists in patients with cirrhosis even if cure of HCV infection is achieved. The risk of these complications is dramatically reduced with cure of HCV infection through antiviral treatment. This article summarizes a presentation by Andrew J. Muir, MD, MHS, at the IAS-USA continuing education program held in Atlanta, Georgia, in September 2013.
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PMID:Cirrhosis in hepatitis C virus-infected patients: a review for practitioners new to hepatitis C care. 2539 70

Direct-acting antiviral (DAA) regimens now allow treatment of previously untreated or treated (including prior DAA failures) patients with chronic hepatitis C virus (HCV) infection with 8 or 12 week regimens, largely without the use of ribavirin. Newer next-generation pan-genotypic regimens with activity against resistance-associated substitutions include glecaprevir/pibrentasvir (GLE/PIB), a combination of a nonstructural protein (NS)3 protease inhibitor and an NS5A inhibitor, and sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX), a combination of an NS5B polymerase inhibitor, NS5A inhibitor, and NS3 protease inhibitor. Both regimens have indications in DAA-experienced patients. GLE/PIB is approved for treatment of patients with genotype 1, 2, 3, 4, 5, or 6 infection without cirrhosis or with compensated cirrhosis and for the treatment of patients with genotype 1 infection previously treated with a regimen containing an NS5A inhibitor or an NS3/4A protease inhibitor, but not the combination. SOF/VEL/VOX is approved for retreatment of patients without cirrhosis or with compensated cirrhosis with genotype 1, 2, 3, 4, 5, or 6 infection previously treated with an NS5A inhibitor-containing regimen, or with genotype 1a or 3 previously treated with a SOF-containing regimen without an NS5A inhibitor. This article summarizes an IAS-USA webinar given by Susanna Naggie, MD, MHS, on August 30, 2018.
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PMID:Treating HCV Infection: It Doesn't Get Much Better Than This. 3064 83