Drug Treatment of Patients with Liver Cirrhosis in a Tertiary Hospital in Northern Ghana: Does It Comply with Recommended Guidelines?

Table 5

Prescriptions not compliant with safety prescribing guidelines ().

Drug	Comment		NP (%); ()
Omeprazole^1	Avoid
	Unsafe	36	36 (23.7)
	Dosing consideration
Omeprazole^2	Maximum dose exceeded	99	78 (51.3)
Spironolactone+furosemide^3	Incorrect dose ratio	93	89 (58.6)
Metronidazole^4	Incorrect dose and frequency	75	64 (42.1)
Paracetamol ^5	Recommended dose exceeded	54	48 (31.6)
Tramadol^6	Higher dosage frequency	32	26 (17.1)

: total number of prescriptions not compliant due to safety; : number of prescriptions made; NP: number of patients who received prescriptions; : total number of patients; 1 = omeprazole is classified as “unsafe” in CPT (Child-Turcotte-Pugh) C; 2 = omeprazole maximum dose is 20 mg/day in CTP A, B, and C (hepatic impairment); 3 = spironolactone : furosemide dose ratio is 100 mg : 40 mg to maximum of 400 mg : 160 mg; 4 = metronidazole requires 50% dose reduction in CTP C (severe hepatic impairment); 5 = paracetamol is recommended at a dose of 2 g/day in CTP A, B, and C (hepatic impairment); 6 = tramadol is recommended at a dose of 50 mg 12 hourly in CTP C (severe hepatic impairment).