Question

A 58-year-old man with decompensated cirrhosis becomes drowsy and disoriented. He has flapping tremor and elevated ammonia levels. No focal neurology is present. What is the most appropriate first-line pharmacological treatment?

Accepted Answer

Oral lactulose

Answer

Intravenous mannitol

Answer

High-dose benzodiazepines

Answer

Oral mesalazine

Answer

Intravenous alteplase

Practice question

A 58-year-old man with decompensated cirrhosis becomes drowsy and disoriented. He has flapping tremor and elevated ammonia levels. No focal neurology is present. What is the most appropriate first-line pharmacological treatment?