Pharmacological challenges in chronic pancreatitis

Anne Estrup Olesen, Anne Brokjaer, Iben Wendelboe Deleuran Fischer, Isabelle Myriam Larsen

Research output: Contribution to journalJournal articleResearchpeer-review

23 Citations (Scopus)

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.
Original languageEnglish
JournalWorld Journal of Gastroenterology
Volume19
Issue number42
Pages (from-to)7302-7307
Number of pages6
ISSN1007-9327
DOIs
Publication statusPublished - 14 Nov 2013

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