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Newer therapies are emerging and currently under study for the management of HE targeting traditional mechanisms of ammonia clearance in addition to novel mechanisms related to altering gut microbiome, reducing inflammation and oxidative stress, protecting endothelial integrity, and modifying neuronal responses (Fig

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Glucocorticoids: The Most Clinically Significant Interaction Glucocorticoids (prednisone, dexamethasone, hydrocortisone, budesonide) blunt the GH response to GHRH stimulation through at least three mechanisms: they increase hypothalamic somatostatin tone, they directly reduce somatotroph sensitivity to GHRH, and they suppress hepatic IGF-1 production independent of GH

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