November 12, 2014
Notes: Oki, Hodaka
J Magn Reson Imaging. 2013 Nov 22. doi: 10.1002/jmri.24508.
Author Address: Department of Radiology, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan.
Reference Type: Journal Article
Record Number: 4737Author: Olesen, A. E., Brokjaer, A., Fisher, I. W. and Larsen, I. M.
Title: Pharmacological challenges in chronic pancreatitis
Journal: World J Gastroenterol
Date: Nov 14
Short Title: Pharmacological challenges in chronic pancreatitis
Alternate Journal: World journal of gastroenterology : WJG
ISSN: 2219-2840 (Electronic)
Accession Number: 24259961
Keywords: Analgesics, Opioid/adverse effects
Exocrine Pancreatic Insufficiency/etiology/metabolism/physiopathology
*Intestinal Absorption/drug effects
Abstract: Drug absorption in patients with chronic pancreatitis might be affected by the pathophysiology of the disease. The exocrine pancreatic insufficiency is associated with changes in gastrointestinal intraluminal pH, motility disorder, bacterial overgrowth and changed pancreatic gland secretion. Together these factors can result in malabsorption and may also affect the efficacy of pharmacological intervention. The lifestyle of chronic pancreatitis patients may also contribute to gastrointestinal changes. Many patients limit their food intake because of the pain caused by eating and in some cases food intake is more or less substituted with alcohol, tobacco and coffee. Alcohol and drug interaction are known to influence the pharmacokinetics by altering either drug absorption or by affecting liver metabolism. Since patients suffering from chronic pancreatitis experience severe pain, opioids are often prescribed as pain treatment. Opioids have intrinsic effects on gastrointestinal motility and hence can modify the absorption of other drugs taken at the same time. Furthermore, the increased fluid absorption caused by opioids will decrease water available for drug dissolution and may hereby affect absorption of the drug. As stated above many factors can influence drug absorption and metabolism in patients with chronic pancreatitis. The factors may not have clinical relevance, but may explain inter-individual variations in responses to a given drug, in patients with chronic pancreatitis.