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DENTAL CONSIDERATION IN LIVER DISORDERS Main problems in management of patients with liver disease • Impaired drug detoxification • Bleeding tendencies • Transmission of viral hepatitis LIVER DAMAGE WILL LEAD TO RISE IN VARIOUS ENZYMES. RELEASED INTO SERUM 1. Serum levels of Aspartate transaminase (serum glutamic oxaloacetate trasaminases SGOT) 2. Alanine transminase (Serum glutamic pyruvate transaminase (SGPT ) 3. Gamma glutamyl transpeptidase (GGT) - 4. Biliary canalicular enzymes such as 5'- nucleotidase and alkaline phosphates Dental aspects of parenchymal liver diseases> IMPAIRED DRUG DETOXIFICATION AND EXCRETION> FACTORS TO BE CONSIDERED:> Amount of the liver damage> Induction of hepatic drug metabolizing enzymes by previous medication> Reduced protein binding capacity due to reduced serum albumin> Tetracycline, erythromycin and aspirin codeine and mefenemic acid should be avoided and instead clindamycin and paracetamol in low doses> Relative analgesia is preferred over general anesthesia.> Barbiturates if administered in liver diseases will cause respiratory depression> Local anesthesia is safely given in normal dose...

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