Prescribing in liver disease

As the liver is responsible for the metabolism of many compounds, knowledge of a patient's hepatic function is required for the safe prescribing of many drugs. Assessing liver function by way of a patient history, examination and blood tests such as serum albumin and bilirubin, as well as prothrombin time, is recommended before prescribing some medications. Liver enzyme concentrations may be useful indicators of hepatocellular damage or enzyme induction. For drugs dependent on hepatic elimination, careful choice of compounds and their dose is prudent if liver function is significantly compromised. Drug interactions must also be considered if a common metabolic pathway exists.