Treating High Ammonia Levels in Cirrhosis

GI & Hepatic · Question from the ATI RN Medical-Surgical 2023 Proctored Exam study set

Correct answer: A. Lactulose

Why this is the answer

Lactulose works by acidifying the colon and increasing stool transit, which traps ammonia in the gut and promotes its excretion — directly treating the hepatic encephalopathy that high ammonia causes. Furosemide (B) is genuinely used in cirrhosis, but for managing fluid overload and ascites, not for lowering ammonia. Omeprazole (C) reduces stomach acid and has no role in ammonia clearance. Metformin (D) is a diabetes medication that is actually generally avoided in significant liver disease and does nothing for ammonia levels.

The bigger concept

A cirrhosis patient's care plan often has several medications targeting different complications at once — lactulose for ammonia/encephalopathy, diuretics for ascites, and beta-blockers for portal hypertension. Recognizing which drug treats which specific complication is a common exam pattern.

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