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Liver Cirrhosis
Lamya Alnaim, PharmD
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Background
Cirrhosis →the end stage of any chronic liver disease.
Hepatitis C and alcohol are the main causes
Two major syndromes result
Portal hypertension
Hepatic insufficiency.
peripheral and splanchnic vasodilatation with the resulting hyperdynamic circulatory state
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Background
Cirrhosis can remain compensated for many years before the development of a decompensating event.
Decompensated cirrhosis is marked by the development of any of the following complications:
Jaundice,
Hemorrhage
Ascites
Encephalopathy.
Other than liver transplantation, there is no specific therapy for this complication.
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Background
Other complications occur as a consequence of PHTN and the hyperdynamic circulation.
Gastroesophageal varices result from PHTN, although hyperdynamic circulation contributes
Ascites results from sinusoidal HTN and sodium retention, which is 2ndry to vasodilatation and activation of neurohumoral systems.
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Background
The hepatorenal syndrome results from severe peripheral vasodilatation that leads to renal vasoconstriction.
Hepatic encephalopathy is a consequence of shunting of blood through portosystemic collaterals (due to PHTN), brain edema (cerebral vasodilatation), and hepatic insufficiency.
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A chronic disease of the liver with wide spread hepatic parenchymal injury and hepatocyte destruction.
It may lead to anatomic and functional abnormalities of blood vessels and bile ducts
Definition
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Causes
Alcohol
Viral illness
Biliary dysfunction
Metabolic disorders
Inherited disorders
Drugs

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