Prevention and treatment of hepatic encephalopathy

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Hepatic encephalopathy is a common neuropsychiatric complication of serious liver diseases and serves as a marker for worsening of their course and increasing the risk of death. The principal pathogenesis factors of hepatic encephalopathy is the excessive formation of ammonia and its accumulation by astrocytes. A key role in the prevention and treatment of hepatic encephalopathy is played by drugs that prevent hyperammonemia and promote the removal of ammonia from the body, namely lactulose, rifaximin and L-ornithine-L-aspartate. L-ornithine-L-aspartate has proven clinical effectiveness in the treatment of hepatic encephalopathy, prevents the transformation of minimal hepatic encephalopathy into overt forms, increases the tolerability of psychotropic drugs used in the treatment of alcohol dependence, and improves cognitive functions.

Keywords:

hepatic encephalopathy

ammonia

hyperammonemia

astrocytes

liver cirrhosis

portosystemic shunting

alcohol liver disease

lactulose

rifaximin

L-ornithine-L-aspartate

Authors:

Sivolap Iu.P.

Moskovskaia meditsinskaia akademiia im. I.M. Sechenova

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