Chronic Liver Disease (CLD)
Protocols
Clinical Features:
- 1)Confusion or problems thinking
- 2)Impotence, loss of interest in sex, and breast development (gynecomastia) in men
- 3)Loss of appetite
- 4)Nausea and vomiting
- 5)Nosebleeds or bleeding gums
- 6)Pale or clay-colored stools
- 7)Small, red spider-like blood vessels on the skin
- 8)Swelling or fluid buildup of the legs and in the abdomen.
- 9)Vomiting blood or blood in stools
- 10)Weakness
- 11)Weight loss
- 12)Yellow color in the skin, mucus membranes, or eyes.
On examination :
- 1) Jaundice :+
- 2)splenomegaly
Investigations:
- 1)Upper GI endoscopy (esophageal varies)
- 2)Serum Bilirubin
- 3)[post id="101" title="SGPT/ALT"]
- 4)PT & [post id="110" title="INR"]
- 5)Usg of W/A
- 6)HBsAg & Anti-HCV
- 7)Ascitic fluid study
Rx:
- Diet:Normal(salt & protein restricted)
- Bef rest
1.Tab.Spirocard(spironolactone)(100mg)
1+0+0.......continue
2.Syp.Avolac([post id="515" title="Lactulose"])
2-6 চামচ ৩ বার...১০দিন
3. Cap.Moxin([post id="402" title="Amoxicillin"])(500mg)
1+1+1.....7 days
4. Cap.Sergel([post id="392" title="Esomeprazole"]) (20mg)
1+0+1.....(খাবার ৩০ মি আগে)....15 days
5. inj.K-one (10mg)
1 amp I/V stat &... For 3-5 days
If portal hypertension :
- Tab.Indever(40mg)...1+0+0......continue
If fever:
- Tab.Napa([post id="449" title="Paracetamol"]) (500mg)...1+1+1........3 days
6. Paracentesis:
Advice:
- 1) Salt & fluid restrictions
- 2) complete bed rest
- 3) alcohol restrictions