pancreatitis Flashcards
causes of acute pancreatitis
- gallstones (40-70%)
- alcohol (25-35%)
- medications (0.1-2%)
mechanisms of drug induced pancreatitis
- duct constriction
- accumulation of toxic metabolites
- hypersensitivity reactions
- hypertriglyceridemia
- hypercalcemia
symptoms of acute pancreatitis
- abdominal pain
- n/v
- hypotension, tachycardia
- low grade fever
diagnosis for acute pancreatitis
at least two of the following:
- abdominal pain
- amylase and/or lipase >3x upper limit of normal
- characteristic findings and abdominal imaging
mild classification of acute pancreatitis
- no organ failure or complications
- usually only requires brief hospitalization
moderate classification of acute pancreatitis
-local complications or short term organ failure <48 hours
severe classification of acute pancreatitis
- persistent organ failure or death
- requires ICU care
goals of therapy for acute pancreatitis
- replace fluids
- relieve abdominal pain and nausea
- manage complications
local pancreatic complications
- necrosis
- peripancreatic fluid collection
- pseudocysts
extrapancreatic complications
- respiratory failure
- infection
treatment of pancreatitis
- fluid resuscitation
- opioids for pain
- antiemetics
- nutrition
- correct underlying cause
fluid resuscitation treatment
250-500 mL
lactated ringer’s preferred over NS
goal of fluid resuscitation
decrease hematocrit and BUN
maintain normal SCr
when to use antibiotics in acute pancreatitis
only if known or suspected infection
those at greatest risk of progressing from acute to chronic pancreatitis
- alcohol related pancreatitis
- tobacco use
