Medical history (history of illness) is an important component in the diagnosis of liver cirrhosis (liver shrinkage). Family history
- Is there a frequent history of metabolic/liver disease in your family?
Social history
Current medical history/systemic history (somatic and psychological complaints).
- What symptoms have you noticed?
- How long have these changes been present?
- Do you often feel tired?
- Have you noticed any changes in your skin?
- Do you have any pain in the upper abdomen? If yes, when?
- Have you noticed an increased tendency to bleed?
- Have you noticed yellowing of the skin and eyes?
- Do you have increased itching?
- Have you noticed any changes in the skin or nails?
- Do you have fatty stools? (grayish, sticky, pungent smelling stools).
- Do you have libido disorders? (question to the man)
- Do you have cycle disorders? What is your cycle length (duration between two cycles, defining each first day of bleeding as the beginning of a new cycle)?
Vegetative anamnesis including nutritional anamnesis.
- Has your body weight changed unintentionally? Please tell us your body weight (in kg) and height (in cm).
- Do you eat a balanced diet?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses per day?
- Do you use drugs? If yes, what drugs (ecstasy, cocaine) and how often per day or per week?
Self history incl. drug history.
- Pre-existing conditions (metabolic diseases, liver disease).
- Operations
- Allergies
- Environmental history (arsenic, formaldehyde)
Drug history (hepatoxic: hepatotoxic drugs/hepatoxic drugs) [list is not exhaustive].
- Allopurinol
- Analgesics (including NSAIDs) – acetylsalicylic acid (ASA), diclofenac, ibuprofen, indometacin, metamizole, acetaminophen (paracetamol), sulindac
- Antiarrhythmic drugs – amiodarone
- Antibiotics
- Aminopenicillins (amoxicillin) – especially often the combination: amoxicillin and clavulanic acid.
- Clavulanic acid
- Gyrase inhibitors – quinolones: ciprofloxacin, levofloxacin, moxifloxacin.
- Isoxazolylpenicillins (so-called staphylococcal penicillins) – oxacillin.
- Ketolides
- Lincosamide antibiotics (lincosamides) – clindamycin
- Macrolide antibiotics (macrolides) – azithromycin, clarithromycin, erythromycin.
- Nitroimidazoles (metronidazole).
- Nitrofurantoin
- Penicillins (flucloxacillin)
- Sulfonamides (sulfasalazine, synonym: salazosulfapyridine).
- Tetracyclines – doxycycline, gentamycin, minocycline.
- Trimethoprim/sulfamethoxazole)
- Antidepressants
- Agomelatine (metabolically stable analog of melatonin); contraindicated in patients 75 years of age and older.
- Dual-serotonergic antidepressants (DSAs) – nefazodone.
- Noradrenergic and specific serotonergic antidepressants (NaSSA) – mirtazapine.
- Selective serotonin reuptake inhibitors (SSRIs) – fluoxetine, paroxetine, sertraline, trazodone.
- Selective dopamine and norepinephrine (slightly also serotonin) reuptake inhibitors (NDRI) – bupropion.
- Tricyclic antidepressants (TCAs) – amitriptyline
- Antiepileptic drugs – carbamazepine, valproate.
- Antihistamines – cyproheptadine
- Antihypertensives – alphamethyldopa, nifedipine, diltiazem, lisinopril, fosinopril, captopril, enalapril,verapamil, losartan, irbesartan.
- Anticoagulants
- Phenprocoumon (product names: Marcumar, Falithrom), Clopidogrel.
- New oral anticoagulants (NOAK, NOAC).
- Direct factor Xa inhibitor (apixaban, edoxaban, rivaroxaban).
- Direct and selective factor Xa inhibitor (apixaban).
- Selective thrombin inhibitor (dabigatran).
- Anticonvulsants – valproic acid, carbamazepine, gabapentin, phenopbarbital, phenytoin.
- Antifungals
- Allylamines (terbinafine)
- Ketoconazole (Ketoconazole)
- Polyene macrolactone (amphotericin, liposomal amphotericin B).
- Antipsychotics (neuroleptics) – carbamazepine, chlorpromazine, phenobarbital, phenothiazines, phenytoin, valproic acid, risperidone.
- Antituberculostatics – isoniazid, pyrazinamide, rifampicin, rifabutin.
- Α-Methyldopa
- Chloral hydrate
- Disulfiram (INN), also tetraethylthiuram disulfide (TETD).
- EGFR tyrosine kinase inhibitor – lapatinib
- Endothelin receptor antagonists (endothelin receptor antagonists) – ambrisentan, bosentan.
- HMG-CoA reductase inhibitors (statins), unspecified.
- Hormones
- Anabolic steroids (anabolic steroids)
- Antiestrogens (tamoxifen)
- Estrogens (ethinyl estradiol, estradiol)
- Oral anticonceptives, unspecified.
- Testosterone
- Immunosuppressants – azathioprine, ciclosporin (cyclosporin A), mercaptopurine.
- Motilin agonist
- Anesthetic (halothane)
- Norepinephrine reuptake inhibitor (atomoxetine).
- Oral antidiabetic agents – acarbose
- Orlistat
- Petadolex (butterbur) [rare].
- Phytopharmaceuticals (herbal medicines) – e.g., Kava Kava, Usnea barbata.
- Proton pump inhibitors (PPIs; acid blockers) – may increase the risk of hepatic encephalopathy in patients with advanced cirrhosis in a dose-dependent manner
- Psychotropic substances such as modafinil [alkaline phosphatase ↑, gamma-GT ↑)
- Pyrrolizidine alkaloids (phytochemical).
- Antivirals – nevirapine, abacavir, amprenavir, fialuridine, ritonavir.
- Cytostatic drugs – anthracyclines, cytarabine, dacarbazine, flutamine, isoniazid, methotrexate (MTX), temozolomide (to organ failure).
- Other – hypertonic saline, vitamin A intoxication, Thorotrast.
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)
