title: Use of contraindicated drugs in patients with chronic liver disease: a therapeutic dilemma.
abstract: OBJECTIVE
  To investigate the prevalence of prescribing of contraindicated drugs or those requiring caution, in hospital inpatients with chronic liver disease.
  
  
  METHODS
  The medical records and drug charts of adult hospitalized patients, consecutively admitted with clinical documentation and biochemical evidence of chronic liver disease, were studied retrospectively. Comparison was made between the prescription details for each drug and the recommendations for use in patients with liver disease under the approved product information, which indicates drugs that could be hepatotoxic and those that could have markedly altered pharmacokinetics or pharmacodynamics in chronic liver disease.
  
  
  RESULTS
  49 eligible patients with both clinical documentation and confirmatory biochemical evidence of chronic liver disease were identified. Of these, 15 had received at least 1 contraindicated medication during hospitalization, with diazepam being the most common. 31 patients had received at least 1 drug which requires precaution in liver disease, with propranolol being the most common.
  
  
  CONCLUSIONS
  The use of contraindicated drugs or those requiring caution, occurred frequently in hospital patients with chronic liver disease. This could reflect the somewhat limited evidence base and the perhaps overly cautious nature of the official product information.
authors.affiliation: Department of Pharmacotherapy, School of Pharmacy, Shahid Beheshti Medical University, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sistanizad
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Peterson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D056486:Chemical and Drug Induced Liver Injury / Q000517:prevention & control; D002908:Chronic Disease; D000075202:Contraindications; D005260:Female; D006801:Humans; D007297:Inpatients; D008099:Liver / Q000187:drug effects; D008107:Liver Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D055553:Prescription Drugs