Which group of drugs is relatively contraindicated in clients with increased liver enzymes?

The group of drugs identified as being relatively contraindicated in clients with increased liver enzymes is the azole antifungals. These medications, which include voriconazole, itraconazole, and fluconazole, are known to have hepatotoxic potential and can exacerbate pre-existing liver conditions. In someone with elevated liver enzymes, the administration of azole antifungals could potentially lead to further liver damage.

In contrast, aminoglycosides, typically used as antibiotics, have renal toxicity as a primary concern rather than liver-related issues. Azelastine, an antihistamine, is primarily related to allergic conditions and does not significantly impact liver function. Beta-lactams, a class of antibiotics that includes penicillins and cephalosporins, are generally considered safer for use in patients with liver enzyme abnormalities, although caution is still advised depending on liver function.

Due to the metabolic pathways involving cytochrome P450 enzymes that azole antifungals utilize, they can cause liver enzyme alterations and require careful monitoring in patients with any baseline liver dysfunction, hence their relative contraindication in this population.