Question

A 57-year-old man with known alcoholic cirrhosis presents with drowsiness, asterixis and elevated serum ammonia. He has no focal neurology or evidence of intracranial bleed. What is the first-line pharmacological treatment for his encephalopathy?

Accepted Answer

Oral lactulose titrated to produce 2-3 soft stools per day

Answer

Intravenous mannitol

Answer

Oral rifaximin monotherapy

Answer

High-dose intravenous benzodiazepines

Answer

No specific therapy; observation only

Practice question

A 57-year-old man with known alcoholic cirrhosis presents with drowsiness, asterixis and elevated serum ammonia. He has no focal neurology or evidence of intracranial bleed. What is the first-line pharmacological treatment for his encephalopathy?