vitamin-k-semiquinone-radical and Pancreatitis

To review the current state of the science regarding intravenous fat emulsions (IVFEs), with an emphasis on their safety profile.. Articles were identified via a search of the MEDLINE database, including publications from 1979 to December 2009, using a search string that included the terms parenteral nutrition, lipid emulsion, fat emulsion, IVFE, safety, adverse effect, neonate intralipid, and terms describing a range of specific adverse events (AEs) such as pancreatitis.. We selected articles that allowed us to compare the results of clinical trials involving delivery of medications via IVFEs with the historical use and effects of IVFEs in parenteral nutrition, with an emphasis on AEs. We focused on 2 drugs in current use that are administered intravenously in lipid emulsions: propofol and clevidipine.. Clearance of the fat particles in IVFEs is mediated by the enzyme lipoprotein lipase. AEs are more likely if the rate or duration of IVFE administration exceeds the enzyme's clearance capacity. AEs are also more likely after administration of a 10% IVFE formulation than a 20% formulation, because the higher concentration of free phospholipid in the 10% formulation interferes with lipoprotein lipase activity. AEs can be reduced by administering IVFEs at a dosage < or = 2.5 g/kg/day and at a rate < or = 0.11 g/kg/h. The anesthetic agent propofol, which is formulated in a 10% IVFE, has been used clinically for 25 years. Typical AEs associated with propofol use include infection, high plasma triglyceride concentrations, and pancreatitis. Recent clinical trials involving clevidipine, which is formulated in a 20% IVFE, have demonstrated a low rate of lipid-related AEs.. The results of this review demonstrate that IVFEs are well tolerated when administered in accordance with guideline recommendations.

Topics: Anticoagulants; Antidotes; Bacteria; Drug Delivery Systems; Drug Interactions; Drug Overdose; Fat Emulsions, Intravenous; Humans; Hypertriglyceridemia; Immune System; Infant, Newborn; Infant, Premature; Infant, Small for Gestational Age; Liver Function Tests; Pancreatitis; Parenteral Nutrition; Respiratory Function Tests; Vitamin K

Topics: Adult; Alkylation; Biological Transport; Celiac Disease; Cholestasis; Dietary Fats; Feces; Humans; Infant; Intestinal Absorption; Intestines; Lipid Metabolism; Malabsorption Syndromes; Oxides; Pancreatitis; Tritium; Vitamin K; Vitamin K 1; Warfarin

Topics: 4-Hydroxycoumarins; Acute Disease; Aged; Duodenal Diseases; Duodenum; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Indenes; Male; Middle Aged; Pancreatitis; Vitamin K

Topics: 4-Hydroxycoumarins; Angiotensin-Converting Enzyme Inhibitors; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Fibric Acids; France; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Indenes; Meta-Analysis as Topic; Pancreatitis; Pharmacoepidemiology; Pharmacovigilance; Pneumonia; Randomized Controlled Trials as Topic; Treatment Outcome; Venous Thrombosis; Vitamin K

Two patients with acute pancreatitis in pregnancy are described. In both, bleeding from vitamin K deficiency occurred after the initial attack of pancreatitis and the bleeding tendency was successfully treated with vitamin K.

Topics: Acute Disease; Adult; Female; Hematuria; Humans; Pancreatitis; Pregnancy; Pregnancy Complications; Vitamin K; Vitamin K Deficiency

Topics: Celiac Disease; Cholestasis; Humans; Intestinal Absorption; Intestine, Small; Pancreatitis; Tritium; Vitamin K

Topics: Antithrombins; Blood Coagulation Tests; Chronic Disease; Humans; Pancreatitis; Thrombelastography; Vitamin K

Topics: Animals; Blood Coagulation; Blood Coagulation Disorders; Ethionine; Heparin Antagonists; Pancreatitis; Rats; Vitamin K