Ibuprofen/famotidine, sold under the brand name Duexis, is a fixed-dose combination medication used for the treatment of rheumatoid arthritis and osteoarthritis. It contains ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) and famotidine, a histamine H2-receptor antagonist. References
Further reading
Deeks ED (September 2013). "Fixed-dose ibuprofen/famotidine: a review of its use to reduce the risk of gastric and duodenal ulcers in patients requiring NSAID therapy". Clin Drug Investig. 33 (9): 689–97. doi:10.1007/s40261-013-0113-x. PMID 23881568. S2CID 24972423. Schiff M, Peura D (February 2012). "HZT-501 (Duexis; ibuprofen 800 mg/famotidine 26.6 mg) gastrointestinal protection in the treatment of the signs and symptoms of rheumatoid arthritis and osteoarthritis". Expert Rev Gastroenterol Hepatol. 6 (1): 25–35. doi:10.1586/egh.11.88. PMID 22149579. S2CID 46369253. External links
"Famotidine mixture with ibuprofen". Drug Information Portal. U.S. National Library of Medicine.
The later stages of fibrosis and cirrhosis tend to be irreversible, but can usually be contained with abstinence for long periods of time. Diagnosis
In the early stages, patients with ALD exhibit subtle and often no abnormal physical findings. It is usually not until development of advanced liver disease that stigmata of chronic liver disease become apparent. Early ALD is usually discovered during routine health examinations when liver enzyme levels are found to be elevated. These usually reflect alcoholic hepatic steatosis. Microvesicular and macrovesicular steatosis with inflammation are seen in liver biopsy specimens. These histologic features of ALD are indistinguishable from those of nonalcoholic fatty liver disease. Steatosis usually resolves after discontinuation of alcohol use. Continuation of alcohol use will result in a higher risk of progression of liver disease and cirrhosis. In patients with acute alcoholic hepatitis, clinical manifestations include fever, jaundice, hepatomegaly, and possible hepatic decompensation with hepatic encephalopathy, variceal bleeding, and ascites accumulation. Tender hepatomegaly may be present, but abdominal pain is unusual. Occasionally, the patient may be asymptomatic. Laboratory findings
In people with alcoholic hepatitis, the serum aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio is greater than 2:1. AST and ALT levels are almost always less than 500. The elevated AST to ALT ratio is due to deficiency of pyridoxal phosphate, which is required in the ALT enzyme synthetic pathway. Furthermore, alcohol metabolite–induced injury of hepatic mitochondria results in AST isoenzyme release.