Pharmacologic Management of Hepatic Encephalopathy.

Nikolaos T Pyrsopoulos, Ali Khalessi

Journal: Clinics in liver disease 2024;28(2):287-296

PMID: 38548440

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Abstract

Hepatic encephalopathy is a common cause of morbidity and mortality among patients with decompensated liver cirrhosis. In this article, we review the history, mechanism, and evidence for first-line pharmacologic therapies for hepatic encephalopathy including nonabsorbable disaccharides, antibiotics, and electrolyte management. We also review newer, second-line therapies including polyethylene glycol, albumin, branched-chain amino acids, probiotics and fecal microbiota transplant, zinc, and l-ornithine-l-aspartate.

Address: Rutgers New Jersey School of Medicine, 185 South Orange Avenue, MSB H-538, Newark, NJ 07103, USA.; Rutgers New Jersey School of Medicine, 185 South Orange Avenue, MSB H-538, Newark, NJ 07103, USA. Electronic address: [email protected].

DOI: 10.1016/j.cld.2024.01.006

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MeSH Terms: Humans, Hepatic Encephalopathy, Lactulose, Anti-Bacterial Agents, Polyethylene Glycols, Zinc, Gastrointestinal Agents