Acute & Chronic pancreatitis, Celiac Flashcards
key concepts for tx of acute pancreatitis
- requires early and aggressive IV fluid resuscitation
- managed similarly to pts w/ sepsis
acute discontinuation of what meds can cause pancreatitis?
meds for diabetes or hyperlipidemia
Do you give prophylactic abx to a pt with acute pancreatitis?
no!
what do you give to pts with ascending cholangitis or necrotizing pancreatitis?
-beta lactam/beta lactase inhibitor (pipercillin/tazobactam)
hallmark complications of chronic pancreatitis
- chronic pain
- malabsorption w/ resultant steatorrhea
- DM
- risk of pancreatic CA
what are the primary treatments for malabsorption due to chronic pancreatitis?(2)
- pancreatic enzyme supplementation (enteric-coated pancreatic enzyme)
- reduction in dietary fat intake
Addition of what may increase the effectiveness of enzyme therapy for malabsorption in chronic pancreatitis?
addition of an antisecretory agent to pancreatic enzyme supplementation
when do pts take pancreatic enzyme supplementation?
during or just after meals
How do pancreatic enzymes help to treat pain a/w pancreatitis?
they help break down CCK (which increases pancreatic secretion)
Normally CCK is inhibited by trypsin but pts w/ chronic pancreatitis have decreased trypsin. So pancreatic enzyme supplements assist with breaking down the CCK
what needs to be considered when treating a patient with Celiac dz?
things often overlooked as sources of gluten:
- oral prescription drugs
- nonprescription drugs
- vitamin and mineral supplements
Pancreatic enzyme supplementation is dosed based on what?
lipase
What analgesic is commonly used first line in chronic pancreatitis?
Tramadol
What is celiac disease a/w?
Hyposplenism
