open access

Vol 12, No 1 (2018)
Case report
Published online: 2018-05-02
Get Citation

Palliative care of patient with decompensated liver cirrhosis

Michał Kazimierz Chojnicki, Maciej P. Bura, Anna Średniawa, Anna Suska, Mikołaj Bartoszkiewicz, Wojciech Leppert
Palliat Med Pract 2018;12(1):59-63.

open access

Vol 12, No 1 (2018)
Case report
Published online: 2018-05-02

Abstract

In this article a case of a patient with decompensated liver cirrhosis in whom an effective pain manage­ment was introduced with a significant reduction of pruritus intensity was submitted. Because of the liver insufficiency the care for cancer patients require a more intense monitoring regarding symptomatic treatment and sometimes causes necessity of resignation from some drugs administration. Even more caution is required during palliative treatment of patients diagnosed with decompensated liver cirrhosis. Schemes of the treatment of decompensated liver cirrhosis comprise many drugs, which are not being used in everyday clinical practice in palliative medicine. The application of these drugs in a depicted pa­tient provided a significant improvement in efficacy of symptom management. Concurrently significant contraindications appeared for the use of drugs, which could be used in patients without liver cirrhosis

Abstract

In this article a case of a patient with decompensated liver cirrhosis in whom an effective pain manage­ment was introduced with a significant reduction of pruritus intensity was submitted. Because of the liver insufficiency the care for cancer patients require a more intense monitoring regarding symptomatic treatment and sometimes causes necessity of resignation from some drugs administration. Even more caution is required during palliative treatment of patients diagnosed with decompensated liver cirrhosis. Schemes of the treatment of decompensated liver cirrhosis comprise many drugs, which are not being used in everyday clinical practice in palliative medicine. The application of these drugs in a depicted pa­tient provided a significant improvement in efficacy of symptom management. Concurrently significant contraindications appeared for the use of drugs, which could be used in patients without liver cirrhosis

Get Citation

Keywords

liver cirrhosis, hepatocelular carcinoma, puritus, paliative care, end-of-life-care

About this article
Title

Palliative care of patient with decompensated liver cirrhosis

Journal

Palliative Medicine in Practice

Issue

Vol 12, No 1 (2018)

Article type

Case report

Pages

59-63

Published online

2018-05-02

Bibliographic record

Palliat Med Pract 2018;12(1):59-63.

Keywords

liver cirrhosis
hepatocelular carcinoma
puritus
paliative care
end-of-life-care

Authors

Michał Kazimierz Chojnicki
Maciej P. Bura
Anna Średniawa
Anna Suska
Mikołaj Bartoszkiewicz
Wojciech Leppert

References (20)
  1. Soleimanpour H, Safari S, Shahsavari Nia K, et al. Opioid Drugs in Patients With Liver Disease: A Systematic Review. Hepat Mon. 2016; 16(4): e32636.
  2. Pierre V, Johnston CK, Ferslew BC, et al. Population Pharmacokinetics of Morphine in Patients With Nonalcoholic Steatohepatitis (NASH) and Healthy Adults. CPT Pharmacometrics Syst Pharmacol. 2017; 6(5): 331–339.
  3. Baumann AJ, Wheeler DS, James M, et al. Benefit of Early Palliative Care Intervention in End-Stage Liver Disease Patients Awaiting Liver Transplantation. J Pain Symptom Manage. 2015; 50(6): 882–886.e2.
  4. Boyd K, Kimbell B, Murray S, et al. Living and dying well with end-stage liver disease: time for palliative care? Hepatology. 2012; 55(6): 1650–1651.
  5. Fattovich G, Stroffolini T, Zagni I, et al. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004; 127(5 Suppl 1): S35–S50.
  6. Krajowy Rejestr Nowotworów. http://onkologia.org.pl/dane-metodologia/ (2016).
  7. Juszczyk J. Choroby wątroby. In: Juszczyk J. ed. Interna Szczeklika. Medycyna Praktyczna, Kraków 2016: 1111–4.
  8. Bai M, Yang Z, Qi X, et al. l-ornithine-l-aspartate for hepatic encephalopathy in patients with cirrhosis: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol. 2013; 28(5): 783–792.
  9. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014; 60(2): 715–735.
  10. Tajiri K, Shimizu Y. Recent advances in the management of pruritus in chronic liver diseases. World J Gastroenterol. 2017; 23(19): 3418–3426.
  11. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: management of cholestatic liver diseases. J Hepatol. 2009; 51(2): 237–267.
  12. Mansour-Ghanaei F, Taheri A, Froutan H, et al. Effect of oral naltrexone on pruritus in cholestatic patients. World J Gastroenterol. 2006; 12(7): 1125–1128.
  13. Bachs L, Parés A, Elena M, et al. Effects of long-term rifampicin administration in primary biliary cirrhosis. Gastroenterology. 1992; 102(6): 2077–2080.
  14. Mayo MJ, Handem I, Saldana S, et al. Sertraline as a first-line treatment for cholestatic pruritus. Hepatology. 2007; 45(3): 666–674.
  15. Imani F, Motavaf M, Safari S, et al. The therapeutic use of analgesics in patients with liver cirrhosis: a literature review and evidence-based recommendations. Hepat Mon. 2014; 14(10): e23539.
  16. Saab S, Konyn PG, Viramontes MR, et al. Limited Knowledge of Acetaminophen in Patients with Liver Disease. J Clin Transl Hepatol. 2016; 4(4): 281–287.
  17. Haberer JP, Schoeffler P, Couderc E, et al. Fentanyl pharmacokinetics in anaesthetized patients with cirrhosis. Br J Anaesth. 1982; 54(12): 1267–1270.
  18. Cone EJ, Gorodetzky CW, Yousefnejad D, et al. The metabolism and excretion of buprenorphine in humans. Drug Metab Dispos. 1984; 12(5): 577–581.
  19. Reddy L, Krajnik M, Zylicz Z. Transdermal buprenorphine may be effective in the treatment of pruritus in primary biliary cirrhosis. J Pain Symptom Manage. 2007; 34(5): 455–456.
  20. Jin SJ, Jung JY, Noh MH, et al. The population pharmacokinetics of fentanyl in patients undergoing living-donor liver transplantation. Clin Pharmacol Ther. 2011; 90(3): 423–431.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Medycyna Paliatywna w Praktyce dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl