supplement pancreatic enzymes (amylase, lipase, proteases) when pancreas is not up to snuff
Pancreatic Enzymes pharmacokinetics
would be destroyed by gastric acids, so often are encapsulated or co-administered with acid suppressants. titrate dosing to patient, administer with meals or snacks, never crush or chew (mucosal/gastric irritation)
Pancreatic Enzymes indications
pancreatic enzyme deficiency (secondary to CF, chronic pancreatitis, pancreatectomy, GI bypass, duct obstruction)
Pancreatic Enzymes contraindications
pts hypersensitive to pork (they are enzymes from pigs)
Pancreatic Enzymes side effects
diarrhea, hyperuricosuria or renal stones (supplements have a high purine content, uric acid is the byproduct of the breakdown of purines)
5-HT3 receptors in the gut mediate contraction of various segments of the GI tract, and their activation can signal nausea. antagonists decrease receptor stimulation on vagal sensory afferent neurons projecting to emetic center in the brainstem. central 5-HT3 receptors that also help mediate nausea are antagonized as well. other consequences include decreased small bowel motility, decreased colonic compliance.
Serotonin Antagonists pharmacokinetics (T 1/2)
prolonged biological half-life -- effect lasts well past the drug's elimination from the circulation.
Serotonin Antagonists indications
nausea, vomiting (especially useful with chemo)
Serotonin Antagonists side effects
constipation (more common) or diarrhea, HA, light-headedness. rare but serious effects include QT prolongation and other EKG changes, alosetron may also cause ischemic colitis.