Hepatic Insufficiency

The safety of drugs is a frequent concern in patient management. This is also the case in cirrhotic patients which represent the challenging population of patients to manage. Currently, there are no guidelines for medical management of liver cirrhosis patients. According to data, adjustment of drug dosage in patients with liver disease should be considered according to the Child-Pugh score. The liver is one of the central organs which has an important role in drug absorption, but also in drug distribution and elimination. The liver affects pharmacokinetics and pharmacodynamics not just through the process of biotransformation but also through processes of blood flow through the liver, the binding capacity of plasma proteins and the excretion of drugs throughout the biliary system, all of which can be highly significant. Therefore, management of this specific group of patients is complicated, and an individual approach is warranted.