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Insulin and Hypertriglyceridemia-Induced Pancreatitis - #PHARMFAX

Gallstones and chronic alcoholism account for a majority of acute pancreatitis cases.

 

Gallstones and chronic alcoholism account for a majority of acute pancreatitis cases. Hypertriglyceridemia-induced pancreatitis is uncommon, but occurs enough to have options in the drug bank. The proposed pathophysiology is that excessive triglycerides break down into fatty acids causing inflammation and hyperviscosity of the pancreas. Abdominal pain, imaging, and triglycerides greater than 1000 mcg/dL confirm a diagnosis. Amylase may be inaccurate given the effects of hypertriglyceridemia on laboratory diagnostics. Our drug bank is ready for these patients. Pain control, nutrition, and hydration is mainstay for all forms of acute pancreatitis. Specifically with hypertriglyceridemia-induced pancreatitis, insulin therapy is utilized to acutely lower triglycerides by activating lipoprotein lipase. Target a 75% reduction within 24 hours, and then work your way down to target serum levels. Stay on top of glucose and electrolytes when using aggressive insulin therapy for any indication. Oral triglyceride lowering therapies can be considered, but lack immediate effects. For severe cases, we can consider plasmapharesis with or without high volume hemofiltration. Hungry for the PHARMFAX? Check out another video on my page, and I hope you learned something new.


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Not medical advice. Educational purposes only. No relationships to report. I hope you learned something new.

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