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End stage + confusion
Hi, my mother is end stage and living in a nursing home at this time. She can no longer walk or get up on her own and comes and goes with her mental alertness. She's been on lactulose but it doesn't seem to be clearing the ammonia from the blood enough so she can communicate clearly. I have been reading about ribivarin and lactulose together can sometimes help with the ammonia. Has anybody dealt with this with any success? Thanks...i just joined and have learned a lot form this community.
I think the drug you are referring to is Rifaximin.
Here is a an excerpt from an article. If you Google "rifaximin encephalopathy" you should find a lot of information. From what I have read it appears that it might be a good approach toy your Mother's problems.
"Rifaximin in the treatment of chronic hepatic encephalopathy.
Puxeddu A, Quartini M, Massimetti A, Ferrieri A.
Department of Internal Medicine, University of Perugia, Italy.
A study was performed to assess the efficacy and tolerability of rifaximin in the treatment of encephalopathy during cirrhosis of the liver. Fifty-five patients suffering from grade 1, 2 and 3 portosystemic encephalopathy, with a mean age of 58.9 years (range 30 to 86 years) were evaluated. The patients were treated for 15 consecutive days with rifaximin, an antibiotic which is not absorbed by the intestinal wall, at a dosage of 1200 mg/day in association with sufficient lactulose to induce 2 or 3 evacuations per day. Combined use of the 2 drugs proved an efficient means of controlling the majority of signs and symptoms. After just a few days, an improvement in the signs of encephalopathy was noted in all patients. The treatment was well tolerated and the patients completed the trial without any drug-related side-effects. The results of our trial, although in the context of an open assessment, confirm the clinical efficacy of rifaximin in association with a non-absorbable disaccharide such as lactulose. The 2 compounds have a synergetic effect in reducing ammonia-producing flora. Its efficacy and good tolerability make rifaximin a valid alternative to the use of aminoglycoside antibiotics associated with disaccharides in the treatment of patients with liver disease, particularly in the case of prolonged therapy."
Mike
Here is a an excerpt from an article. If you Google "rifaximin encephalopathy" you should find a lot of information. From what I have read it appears that it might be a good approach toy your Mother's problems.
"Rifaximin in the treatment of chronic hepatic encephalopathy.
Puxeddu A, Quartini M, Massimetti A, Ferrieri A.
Department of Internal Medicine, University of Perugia, Italy.
A study was performed to assess the efficacy and tolerability of rifaximin in the treatment of encephalopathy during cirrhosis of the liver. Fifty-five patients suffering from grade 1, 2 and 3 portosystemic encephalopathy, with a mean age of 58.9 years (range 30 to 86 years) were evaluated. The patients were treated for 15 consecutive days with rifaximin, an antibiotic which is not absorbed by the intestinal wall, at a dosage of 1200 mg/day in association with sufficient lactulose to induce 2 or 3 evacuations per day. Combined use of the 2 drugs proved an efficient means of controlling the majority of signs and symptoms. After just a few days, an improvement in the signs of encephalopathy was noted in all patients. The treatment was well tolerated and the patients completed the trial without any drug-related side-effects. The results of our trial, although in the context of an open assessment, confirm the clinical efficacy of rifaximin in association with a non-absorbable disaccharide such as lactulose. The 2 compounds have a synergetic effect in reducing ammonia-producing flora. Its efficacy and good tolerability make rifaximin a valid alternative to the use of aminoglycoside antibiotics associated with disaccharides in the treatment of patients with liver disease, particularly in the case of prolonged therapy."
Mike
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