Which patient should not be administered ketoconazole for Cushing's disease?

Ketoconazole is an antifungal medication that is also utilized in the treatment of Cushing's disease due to its ability to inhibit cortisol synthesis. However, one of the critical considerations when prescribing ketoconazole is its potential hepatotoxicity. This means that the drug can adversely affect the liver, leading to further complications in patients who already have liver issues.

In a patient with elevated liver function tests, it is indicative that there is existing liver impairment. Administering ketoconazole in this scenario poses a significant risk because it can exacerbate liver problems, potentially leading to severe liver damage or failure. Therefore, it is prudent to avoid ketoconazole in patients with elevated liver function tests to ensure patient safety and to prevent the progression of liver-related health issues.

Other conditions such as fatigue, headaches, or even a recent diagnosis of hepatitis C might not present the same immediate risk associated with administering ketoconazole. Therefore, the presence of elevated liver function tests is a clear contraindication for ketoconazole therapy in Cushing's disease.