Pharmacology · single question
For a patient with LIVER CIRRHOSIS requiring pain management, which analgesic is contraindicated?
Show answer and explanation
Correct answer: B. Ibuprofen (NSAIDs are contraindicated in cirrhosis)
✓ B) Ibuprofen (NSAIDs) is the answer to AVOID in liver cirrhosis.
Pain management in cirrhosis: NSAIDs (ibuprofen) are CONTRAINDICATED: inhibit prostaglandins (needed to maintain renal perfusion in cirrhosis) → hepatorenal syndrome + GI bleeding risk + platelet inhibition (already coagulopathic). Acetaminophen: at reduced dose (≤2g/day) is actually the first-line for mild pain — metabolized by glucuronidation (less CYP-dependent in cirrhosis). Opioids: caution, reduced dose. Hydromorphone is the opioid of choice in renal/hepatic impairment. The key board answer: NSAIDs/ibuprofen = contraindicated in cirrhosis.
Pain management in cirrhosis: NSAIDs (ibuprofen) are CONTRAINDICATED: inhibit prostaglandins (needed to maintain renal perfusion in cirrhosis) → hepatorenal syndrome + GI bleeding risk + platelet inhibition (already coagulopathic). Acetaminophen: at reduced dose (≤2g/day) is actually the first-line for mild pain — metabolized by glucuronidation (less CYP-dependent in cirrhosis). Opioids: caution, reduced dose. Hydromorphone is the opioid of choice in renal/hepatic impairment. The key board answer: NSAIDs/ibuprofen = contraindicated in cirrhosis.