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Hepatic encephalopathy

Also known as Portosystemic Encephalopathy and Coma Hepaticum

Hepatic encephalopathy (also known as portosystemic encephalopathy) is the occurrence of confusion, altered level of consciousness, and coma as a result of liver failure. In the advanced stages it is called hepatic coma or coma hepaticum. It may ultimately lead to death.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with hepatic encephalopathy, 69% report having depressive or psychotic symptoms, 42% report having sharp abdominal pain, and 36% report having shortness of breath.


What might my doctor prescribe?

Common Tests and Procedures

Patients with hepatic encephalopathy often receive hematologic tests, complete blood count, radiographic imaging procedure, plain x-ray, electrocardiogram, kidney function tests, intravenous fluid replacement and electrolytes panel .

Common Medications

The most commonly prescribed drugs for patients with hepatic encephalopathy include lactulose, spironolactone, naloxone (suboxone), propranolol, levocarnitine, neomycin (septa), vitamin a, zinc sulfate, sodium polystyrene sulfonate (kayexalate), zosyn, thiamine, haloperidol and rifaximin .

Lactulose
$24
(21 days)
Spironolactone
$11
(28 days)
Naloxone (Suboxone)
Under $1
(0 days)
Propranolol
$18
(28 days)
Levocarnitine
$86
(28 days)
Neomycin (Septa)
$51
(14 days)
Vitamin A
$2
(28 days)
Zinc Sulfate
$4
(28 days)
Sodium Polystyrene Sulfonate (Kayexalate)
$57
(14 days)
Zosyn
$520
(7 days)
Thiamine
$3
(28 days)
Haloperidol
$28
(28 days)
Rifaximin
$680
(21 days)

Who is at risk?

Groups of people at highest risk for hepatic encephalopathy include age 75+ years, age 60-74 years and age 45-59 years. On the other hand, age 5-14 years and age < 1 years almost never get hepatic encephalopathy.

Age

< 1 years
0.0x
1-4 years
0.4x
5-14 years
0.0x
15-29 years
0.1x
30-44 years
0.4x
45-59 years
1.9x
60-74 years
2.4x
75+ years
1.5x

Sex

Male
1.2x
Female
0.8x

Race/Ethnicity

Black
0.8x
Hispanic
1.3x
White
1.0x
Other
0.8x
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