Parallel Session B

Pain relief in patients with liver impairment

Biography
Sarah has worked within Liver services at King’s for the last five years, becoming Pharmacy Team Leader two years ago.  King’s is a tertiary referral Liver unit, caring for patients with all types of Liver Disease and has the largest Liver Transplant programme in Europe.  She qualified as an independent prescriber in 2007 and has established a Pharmacist role in the Viral Hepatitis Clinic.  Sarah, along with Anja St Clair-Jones and Joyeta Das established the UK Clinical Pharmacy Association Gastroenterology and Hepatology group last year.

Abstract
Liver disease is becoming increasingly common and is estimated to cause over 7500 deaths per year in the United Kingdom.  As the liver is the main site of drug metabolism, it can be difficult to safely prescribe drug therapy to patients with liver dysfunction.  In particular, effective use of analgesia in this patient population can be problematic with concerns over metabolism and side-effects of analgesics often leading to sub-optimal pain management.

The aim of this session is to increase confidence in prescribing analgesia for patients with liver dysfunction.  The session will provide an overview of the pharmacokinetic and pharmacodynamic changes that can occur in patients with liver dysfunction and how these affect prescribing choices for the commonly used analgesics.  Appropriate routes of administration, formulation choice, monitoring and use of adjunctive agents to manage side-effects will also be discussed.