Muscle cramps!
We have all had them
But imagine they woke you up every night
For many people with #cirrhosis, that's life!
A #livertwitter #tweetorial featuring:
Who
Why
What to do
#meded #medtwitter #MedStudentTwitter
1/7
We have all had them
But imagine they woke you up every night
For many people with #cirrhosis, that's life!
A #livertwitter #tweetorial featuring:



#meded #medtwitter #MedStudentTwitter
1/7
Cramps in #cirrhosis
Mainly @
,in the
, intense
Common: 1 in 3 people
Risk factors? anyone cramps! No diff in labs!
Turns quality of life into
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2/
But why cramps in #cirrhosis

ATP in muscle of ppl w/cirrhosis
ATP needed for myosin to detach from actin
cramping in cirrhosis associated with
plasma volume &
renin activity
Nerve perfusion depends on volume
&
vol also
sympathetic nerve activity
3/








&


3/
Muscle cramps suck
So let's treat them
Incomplete list:

plasma volume
Hypertonic IVF works 4 dialysis cramps(Fig1)
some ppl use
Juice
Albumin works for #cirrhosis cramps(Fig2)
(
Juice trial pending)
Quinine?(Fig3)
Taurine?(Fig4)
Baclofen?
4/
So let's treat them
Incomplete list:



some ppl use


(




4/
QUININE

muscle excitability(Fig1)
creates a 'refractory period'
FDA says
use (
risk of
disorders)
Taurine
May reduce Ca2+ influx 2 muscle(Fig2)
May work(Fig3)
#RedBull 4 all?
Baclofen

GABA motorneuron signal
May work(Fig4)
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Taurine




Baclofen




5/
Cramps in #cirrhosis: a summary
Common (33%)
Causes:
-
muscle ATP
-
plasma volume
(
flow2nerves, vasoconstriction)
Trashes quality of life
Treatable. But first u have to ask!
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-

-

(




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This concludes a #tweetorial on cramps in #cirrhosis
Hope you enjoyed!
I also hope
we
awareness of often overlooked symptoms
That we can seize this telehealth moment to focus on what matters most 2 patient, use our video visits 2 solicit & address symptoms
Fin
Hope you enjoyed!
I also hope



Fin