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Hepatology

liver
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Agents used in Hepatic Encephalopathy

Lactulose

Acute Hepatic encephalopathy or portosystemic encephalopathy (PSE):
Adults: Oral: 20-30 g (30-45 ml) every 1-2 hours to induce rapid laxation. Adjust dosage daily to produce 2-3 soft stools. Doses of 30-45 ml may be given hourly to cause rapid laxation, then reduce to recommended dose.
Usual daily dose: 60-100 g (90-150 mL) daily. Rectal administration: 200 g (300 ml) diluted with 700 ml of H20 or NS - administer rectally via rectal balloon catheter and retain 30-60 minutes every 4-6 hours

Neomycin (secondary agent)

Hepatic encephalopathy: Oral: 500 to 2000 mg every 6 to 8 hours or 4 to 12 g/day divided every 4 to 6 hours for 5 to 6 days.

Chronic hepatic insufficiency: Oral: 4 g/day for an indefinite period.

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Reference: National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.  Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.
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