Therapeutic Update in Hepatic
Encephalopathy and Management Decisions
This activity is an archive of the live session held at the 2010 Fall Managed Care Forum. If you participated in the live activity, you are not eligible for continuing education credits from this archive.

This activity is valid from January 24, 2011 to December 31, 2011.
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Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This activity is supported by an educational grant from Salix Pharmaceuticals

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Instructions for CME/CEU:  View the presentation, answer the post test, complete the evaluation form and submit.  A score of 70% must be achieved on the post test to receive continuing education credits. You will have the option on the post test/evaluation page to submit your forms electronically or by faxing them to Katie Eads at 804-747-5316.

Description
Hepatic encephalopathy (HE) is a brain disorder caused by chronic liver failure, particularly in alcoholics with cirrhosis, which results in cognitive, psychiatric, and motor impairments. In HE, toxins such as ammonia and manganese can accumulate in the blood and enter the brain, where they can damage nerve cells and supporting cells called astrocytes. Positron emission tomography analyses have determined that ammonia levels are elevated in the brains of HE patients; ammonia accumulation can alter the expression of various important brain genes. Magnetic resonance images show that manganese is deposited in a brain area called the globus pallidus; manganese deposits may be responsible for structural changes in the astrocytes that are characteristic of HE. Treatment of patients with HE involves measures to lower ammonia levels in the blood, medications to counteract ammonia’s effects on brain cell function, devices to compensate for liver dysfunction, and liver transplantation.

Upon Completion of this activity, participants will be able to:

  • Learn about present HE diagnostic and management decisions

  • Understand and update important treatment algorithms

  • Review and understand the pharmacoeconomics of HE.

Faculty: Guy Neff, MD, MBA
Chief of Hepatology, Life Link Transplant Program

Disclosure:

 Dr. Neff serves as a consultant to Genentech, 3 Rivers, and Salix Pharmaceuticals, and is on the speakers bureau for Genentech, 3 Rivers, Bayer, Bristol-Myers Squibb, Gilead Sciences, and Salix Pharmaceuticals. Based on his potential conflict of interest, his presentation has been peer reviewed for evidence base and fair balance.
  Planning Committee:
Bill Williams, MD has no real or perceived financial relationships to disclose.
Katie Eads has no real or perceived financial relationships to disclose.
  NAMCP and/or the presenter has copyright or has received permissions for use of materials provided in this activity.

Accreditation & Designation
The National Association of Managed Care Physicians (NAMCP) is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. NAMCP designates this activity for a maximum of 1 AMA PRA Category I creditsTM.  Each physician should claim credit commensurate with the extent of their participation in the activity.

The American Association of Managed Care Nurses (AAMCN) has been approved as a provider of continuing education by the Virginia Nurses Association (VNA).  VNA is accredited as an approver of continuing education in nursing by the American Nurses Credentialing Center’s Commission on Accreditation. Nurses who complete this activity will be awarded 1 contact hours.

This activity has been approved by the American Board of Managed Care Nursing for 1 contact hours toward CMCN recertification requirements.
   

This activity is supported by an educational grant from Salix Pharmaceuticals
 

NAMCP and or this website does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health related concern, consult with your physician or healthcare professional.