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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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