Pharmacology · single question
Which medication should a dentist avoid prescribing to a patient with liver cirrhosis?
Show answer and explanation
Correct answer: B. NSAIDs
NSAIDs are contraindicated in liver cirrhosis for multiple reasons: (1) cirrhotic patients rely on prostaglandins to maintain renal perfusion — NSAIDs inhibit prostaglandins, risking hepatorenal syndrome; (2) NSAIDs increase risk of variceal bleeding by affecting platelet function; (3) NSAIDs are metabolized by CYP enzymes which are impaired in cirrhosis. Acetaminophen at reduced doses (≤2g/day) is actually the preferred analgesic in cirrhosis — not NSAIDs.
- A. ❌ Acetaminophen at reduced dose (≤2g/day) is the preferred first-line analgesic in liver cirrhosis — safer than NSAIDs or opioids.
- B. ✅ CORRECT – NSAIDs are contraindicated in liver cirrhosis due to risk of hepatorenal syndrome, variceal bleeding, and impaired metabolism.
- C. ❌ Azithromycin is generally safe in liver disease, though it undergoes some hepatic metabolism.
- D. ❌ Amoxicillin is generally safe in liver disease at standard doses.