Case scenario

Mr Lindsay, 34 years, presents to your community pharmacy. He is known to have alcohol dependence and you are aware of two recent admissions to hospital. Mr Lindsay asks you for a box of 100 paracetamol 500 mg tablets and Codral Day and Night. He tells you he is feeling acutely unwell, has hardly been eating for the past week, and has increased his alcohol consumption (daily bottle of wine). Mr Lindsay appears to be a little yellow in the eyes, and when pressed about how he is using these medicines, he responds, ‘I’ve been having a few tablets of each, a couple of times per day, for a few weeks’. What are your actions?

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Discuss which medicines and complementary medicines need to be avoided
  • Describe when dose adjustments are required
  • Explain how pharmacists can help manage patients with liver dysfunction.

Competency standards (2016) addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.5

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Introduction

The liver is the largest solid organ and gland in the body, accounting for approximately 2% of an adult’s body weight. It holds 13% of the body’s blood supply at any given moment and has a major role in filtering blood to remove endogenous and exogenous substances, includin

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