Pharmacology · single question
In a patient with liver cirrhosis requiring dental treatment, which analgesic should be AVOIDED?
Show answer and explanation
Correct answer: B. Acetaminophen (Paracetamol)
✓ B) Acetaminophen should be avoided (or used with extreme caution).
Acetaminophen is hepatotoxic — it is metabolized by the liver and its toxic metabolite (NAPQI) accumulates in hepatic impairment, worsening liver damage. NSAIDs (ibuprofen) also need caution (GI bleeding, renal effects, platelet inhibition), but acetaminophen is specifically contraindicated in significant liver disease. Neither is ideal, but acetaminophen is more directly hepatotoxic.
Acetaminophen is hepatotoxic — it is metabolized by the liver and its toxic metabolite (NAPQI) accumulates in hepatic impairment, worsening liver damage. NSAIDs (ibuprofen) also need caution (GI bleeding, renal effects, platelet inhibition), but acetaminophen is specifically contraindicated in significant liver disease. Neither is ideal, but acetaminophen is more directly hepatotoxic.