Drug used to prevent hepatorenal syndrome in case of alcoholic hepatitis
|B||S- adenosyl-L- methionine|
a. Silymarin - extracted from milk thistle - silybum marinum. It has free radical scavenging, antioxidant, anti-inflammatory. Iron chelating and membrane stabilizing properties. It has the ability to selectively stimulate hepatocyte proliferation.
b. S-adenosyl methionine - It is the source of cysteine for production of GSH. In cirrhosis S-adenosyl methionine synthase activity is reduced. So supplementation of S-adenosyl methionine increases survival.
c. Methylprednisolone, 32 mg/d orally, or the equivalent, for 1 month, may reduce short-term mortality in patients with alcoholic hepatitis
d. Pentoxifylline- It is a dimethyl xanthine derivative used as an adjunct in peripheral vascular disease. It decreases blood viscosity and also decreases RBG's and platelet aggregation and improves blood flow. It is shown to improve short-term (4 wks) survival in pts of alcoholic hepatitis whose benefit is attributed to significant decrease in development of hepato-renal syndrome.
e. So all the above drugs can be given to alcoholic hepatitis patients but heaptorenal toxicity, in particular, is decreased by giving Pentoxifylline.