cardiovascular-agents and Pancreatitis

Continuous regional arterial infusion (CRAI) is a drug delivery system, which dramatically increases the drug concentration in the pancreas. Previous clinical and basic studies have demonstrated the possible therapeutic efficacy of CRAI for severe acute pancreatitis (SAP). This meta-analysis of all published randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of CRAI for the treatment of SAP.. Up to August 10, 2014, RCTs comparing CRAI with intravenous infusion for SAP in PubMed, Embase, EBSCO, MEDLINE, Science Citation Index Expanded, Cochrane Library, China Academic Journals Full-Text Database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database were selected by two independent reviewers. The relative risk (RR) and their 95% confidence intervals (CI) for duration of elevated serum amylase and urine amylase, duration of abdominal pain, infection rate, incidence of complication, overall mortality, curative rate, hospital stay and details of subgroup analysis were extracted. Meta-analyses were made using the software Review Manager (RevMan version 5.10).. Six RCTs with 390 patients meeting the inclusion criteria were included in the final analysis. Compared with intravenous infusion route, CRAI significantly shortened the duration of elevated urine amylase (MD=-2.40, 95% CI=-3.20, -1.60; P<0.00001) and the duration of abdominal pain (MD=-1.46, 95% CI=-1.94, -0.98; P<0.00001), decreased the incidence of complication (RR=0.35, 95% CI=0.15, 0.81; P=0.01) and overall mortality (RR=0.25, 95% CI=0.08, 0.78; P=0.02), shortened the duration of hospital stay (MD=-10.36, 95% CI=-17.05, -3.68; P=0.002), and increased the curative rate (RR=1.66, 95% CI=1.13, 2.46; P=0.01). No mortality and catheter-related infections due to CRAI administration was reported in these studies. Subgroup analysis showed that the combination of drug administration via CRAI did not significantly improve the outcomes.. CRAI is effective for the treatment of SAP, and the combination of drug administration via CRAI did not have a significant effect on the improvement of the outcomes.

Topics: Acute Disease; Anti-Bacterial Agents; Anti-Inflammatory Agents; Cardiovascular Agents; Catheterization, Peripheral; Chi-Square Distribution; Humans; Infusions, Intra-Arterial; Odds Ratio; Pancreatitis; Protease Inhibitors; Randomized Controlled Trials as Topic; Risk Factors; Severity of Illness Index; Treatment Outcome

Topics: Anti-Infective Agents; Anti-Inflammatory Agents, Non-Steroidal; Antineoplastic Agents; Azathioprine; Cardiovascular Agents; Didanosine; Drug-Related Side Effects and Adverse Reactions; Humans; Pancreatitis; Psychotropic Drugs; Reference Standards; Time Factors; Valproic Acid

Topics: Acinar Cells; Animals; Apoptosis; Calcium; Cardiovascular Agents; Escin; Gene Expression Regulation; Male; Mitogen-Activated Protein Kinase 1; Mitogen-Activated Protein Kinase 3; Pancreatitis; Rats; Rats, Sprague-Dawley; Reactive Oxygen Species; STAT3 Transcription Factor

Many drugs are believed, clinically, to cause acute pancreatitis. We used information held on the UK General Practitioner Research Database to compare risks for drugs for which reports of pancreatitis were common or uncommon.. Drug prescriptions were examined in 3673 patients with acute pancreatitis and in matched controls. Odds ratios were calculated for recent (1-90 days before the episode), past (91-360 days before the episode) or continuing (prescription in both periods) use.. Odds ratios were markedly increased for recent antisecretory use in non-ulcer patients only [all H2-antagonists, 12.4 (9.5-16.4); all proton pump antagonists, 9.3 (6.6-13.0)], with smaller increases for past [3.1 (2.5-3.7) and 3.5 (2.6-4.6), respectively] and continuing [2.6 (2.2-3.1) and 3.7 (2.9-4.7), respectively] use in patients without ulcer. Recent users of mesalazine showed a markedly increased risk [9.0 (1.8-44.6)], with smaller increases in past and continuing users [4.5 (1.3-16.0) and 2.5 (1.2-5.0), respectively]. Odds ratios for other drugs, suspect or not, were modestly increased, irrespective of whether the use was recent, past or continuing. The presence of gall-stones was not associated with a modified risk.. Mesalazine, azathioprine and antisecretory drugs in non-ulcer subjects may increase the risk of pancreatitis, but warnings of drug-induced pancreatitis are generally not accompanied by increased population risks.

Topics: Acute Disease; Adverse Drug Reaction Reporting Systems; Antiviral Agents; Cardiovascular Agents; Central Nervous System Agents; Gastrointestinal Agents; Humans; Immunosuppressive Agents; Logistic Models; Odds Ratio; Pancreatitis; Population Surveillance; Regression Analysis; Risk Factors

Vomiting, abdominal distension, and feeding intolerance are common findings following brain injury in children, and are usually attributed to the brain injury or to delayed gastric emptying: a specific cause is usually not sought. We report six children who developed mild to moderate pancreatitis at least 7 days following apparently isolated brain injury, a previously unreported association. Five of the six patients received drugs that are known or suspected pancreatotoxins; all recovered without changes in the medications. When children develop feeding intolerance or upper gastrointestinal symptoms following traumatic brain injury pancreatitis should be suspected.

Topics: Acute Disease; Adolescent; Anti-Bacterial Agents; Anticonvulsants; Brain Injuries; Cardiovascular Agents; Child; Child, Preschool; Female; Head Injuries, Closed; Hematoma, Subdural; Humans; Male; Pancreatitis; Psychotropic Drugs; Risk Factors; Wounds, Gunshot

Topics: Aprotinin; Cachexia; Cardiovascular Agents; Chloramphenicol; Drug Therapy; Muscle Relaxants, Central; Pancreas; Pancreatitis; Penicillins; Procaine; Toxicology; Trypsin Inhibitors

Topics: Carbohydrates; Cardiovascular Agents; Child; Chlorpromazine; Humans; Meperidine; Mumps; Muscle Relaxants, Central; Pancreatitis

Topics: Cardiovascular Agents; Hexamethonium; Muscle Relaxants, Central; Pancreatitis