Most opioids are at least partially metabolized by the liver, complicating their use in liver failure. This Fast Fact discusses the use of opioids in patients with liver failure (see also Fast Facts #161 about opioid use in renal Most opioids are at least partially metabolized by the liver, complicating their use in liver failure. This Fast Fact discusses the use of opioids in patients with liver failure (see also Fast Facts #161 about opioid use in renalfailure,#176and#177aboutmanagingascites,and#189about prognostication in end-stage liver disease: www.mcw.edu/ eperc). While there are plenty of pharmacokinetic data about opioids and liver failure, all the clinical recommendations below are rational and empiric, but not based on clinical outcomes research.
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