Prospective Study of Drugs Used to Treat Hepatic Impairment Patients with or without Comorbidities at a Tertiary Care Teaching Hospital in Davangere

Abstract

Background The principal location for drug metabolism is the liver the biggest organ in the body. This process primarily functions as a detoxification mechanism turning pharmacologically active lipid-soluble medicines into inactive hydrophilic metabolites that may be eliminated by kidneys. In some cases the conversion of pro-drugs into their active components also requires metabolic enzymes. Hydrophilic medications are more significant for renal excretion than lipid-soluble pharmaceuticals which are more vital for liver metabolism. The liver plays a crucial role in metabolizing and detoxifying both internal and external substances. Any harm to this vital organ can greatly affect its ability to combat bacterial and parasitic infections as well as damage caused by alcohol poisonous mushrooms toxins and medications.Objectives Primary objective of this study was to evaluate the prescribing patterns of drugs in hepatic impairment patients with or without comorbidities admitted to the inpatient general medicine wards of a tertiary care teaching hospital. Secondary objectives were to categorize the patients based on Child-Pugh score Maddreyrsquos score to evaluate the prescription pattern of non hepatospecific drugs and to analyse the distribution of patients according to social habits.Methods and Results This prospective observational study was conducted at a tertiary care teaching hospital in Chigateri District Hospital Davangere for a period of six months. In our study males were found to be suffering more from hepatic impairment compared to females. The most prevalent hepatic impairment observed was chronic liver disease CLD accompanied by hypertension. The comorbid conditions involved in CLD patients were evaluated and the most common comorbid conditions observed were hypertension and hepatic encephalopathy along with CLD. The major complication of liver disease were found to be anaemia thrombocytopenia pancreatitis ascites and portal hypertension.Conclusion The prescription pattern of diuretics and gall stone dissolution agents were more common among hepatospecific drugs and antibiotics antiulcer agents and nutritional supplements were prescribed more among non-hepatospecific drugs.