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Cirrhosis Community › Cirrhosis Articles › Safe Pain Releif
|Safe Pain Releif|
|Written by mpmom|
|29 December 2009|
A article By Dr. Jennifer Pate apearred in Liver Health Today. Below are high lights from this article
Safe pain relief for liver patients
article by Dr. Jennifer Pate
Liver Health Today
Tylenol : The preferred pain reliever. Is generally thought to be safe in patients with liver disease in doses up to 2000mg in a 24 hour period. Make certain that you check all medications for Tylenol, also called Acetaminophen and APAP.
NASIDS : Are a problem for liver patients. And have been frequently associated with liver injury.
Hep C patients have a increased risk for major liver damage from Motrin.
nsaids may cause salt and water retention and may worsen edema and ascites. Varices may be worsen and life threatening bleeding may occur. Patients with severe liver disease may suffer from kidney damage from nsaids.
Note; some heart patients may have to use aspirin therapy , make certain that your Liver Dr. is aware of all meds you are taking.
Darvocet: At regular doses provides limited benefit.( Not much different than Tylenol alone. Higher doses are a major cause of drug related deaths. The FDA is considering pulling it from the market
It interferes with heart function, causes confusion and seizures.
Demerol: Has many neurological side effects including seizures. If used it should be limited to procedures only.
Codeine: Many people have trouble metabolizing codeine resulting in nausea , vomiting or confusion.. Liver patients can not metabolize codeine to it's active form (Morphine)
Morphine: is difficult for liver patients to process and may cause seizures, confusion and respiratory problems and decreased blood pressure.
Vicodin , Lorcet , Lortab: Is safe in most liver patients.
Tramadol: (Ultram) works well for liver patients but should not be used with some antidepressants . The combination can cause seizures.
Dilaudid: Can be used short term for severe pain.
Fentanyl patch: Is a strong medication but causes less nausea, confusion and constipation.
Neurontin , Lyrica ; Are safe in liver patients
Cymbalta : Is problematic for liver patients causing constipation, sedation , weight gain , and confusion.
Methadone : Can be helpful but must be monitored closely in Liver patients.
Lidoderm patches : work well for local pain
Dr. Pate is a psychiatrist that specializes in patients with Liver disease. half of her patients have Hep C and the other half are waiting for a transplant.
She has a private practice in Houston.
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