Rx that is liver safe

they are probably referring to the enterohepatic cycling which occurs through the liver and increases the half life and duration of drug action. examples would be almost all of the opioid narcotics (codeine, heroin, morphine), most of the nsaids (non-steroidal anti-inflammatory drugs) and that includes salicylates (aspirin), ibuprofen, ibuprofen, indomethacin, ketorolac, ketoprofen, naproxen and prioxicam to name a few and tylenol (acetaminophen). an overdose of acetaminophen will cause acute liver failure and death. that pretty much covers all the analgesics and it seems that they are all metabolized through the liver, doesn't it? mostly, what i have seen in my nursing practice is that the doctors order very low doses of the pain medications mentioned above if needed in patients with liver diseases.

however, there is one analgesic that i can think of that may be used for people with liver failure or compromised liver function that is metabolized by the kidneys. it is ultram (tramadol). it is classified as a central analgesic or nonopiod receptor active drug. unfortunately, i cannot find any other examples in this same classification.

thank you so much.... the professor said that in a pt. with end stage damage to use that type of rx. i appreciate youtr help.