Table 3.

Potential Mechanisms of Action of Agents Used to Treat Cramps in Cirrhotic Patients

Agent	Mechanism of action	Route of administration (dose studied)	Side effects
Quinidine sulfate	Increases the muscle refractory period and decreases the excitability of motor end plate to nerve stimulation	Oral (400 mg daily)	Mild diarrhea, thrombocytopenia, cardiac arrhythmias, cinchonism
Vitamin E	Important antioxidant in the cell membrane that acts to decrease circulating free radicals	Oral (200 mg 3 times daily)	None reported
Human albumin	Expansion of plasma volume and improvement of hypovolemia and possible subsequent ischemia to neurons	Intravenous (100 mL 25% human albumin solution)	None reported
Zinc	Unknown	Oral (220 mg twice daily)	Mild diarrhea
Taurine	Sarcolemma stabilization via calcium channel regulation and conductance	Oral (3 g daily)	None reported
Eperisone hydrochloride	Centrally acting muscle relaxant	Oral (150–300 mg daily)	Dizziness, fatigue, and epigastric discomfort
Branched-chain amino acids	Increases serum albumin and taurine production	Oral (4 g granules 3 times daily)	None reported