Lactulose is considered the first-line treatment for hepatic encephalopathy and works by:
a. causing ammonia to enter the bloodstream via the colon.
b. trapping ammonia in the bowel for excretion.
c. causing constipation and inhibiting the excretion of ammonia.
d. creating an alkaline environment in the bowel.
B
Lactulose is considered the first-line treatment for hepatic encephalopathy. Lactulose creates an acidic environment in the bowel that causes the ammonia to leave the bloodstream and enter the colon. Ammonia is trapped in the bowel. Lactulose also has a laxative effect that allows for elimination of the ammonia. Lactulose is given orally or via a rectal enema.
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