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Drug-induced pancreatitis

T W Underwood1, C B Frye

  • 1Deaconness Hospital, Evansville, IN.

Clinical Pharmacy
|June 1, 1993
PubMed
Summary

Identifying drugs causing pancreatitis is crucial due to significant morbidity and mortality. This review summarizes agents with definite, probable, and questionable associations with drug-induced pancreatitis.

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Area of Science:

  • Pharmacology
  • Gastroenterology
  • Toxicology

Background:

  • Drug-induced acute pancreatitis, though infrequent, carries significant morbidity and mortality.
  • Timely identification of the causative agent is essential for patient management.
  • Understanding the mechanisms of drug-induced pancreatitis aids in diagnosis and prevention.

Purpose of the Study:

  • To summarize current information on drugs implicated in causing pancreatitis.
  • To categorize drugs based on the strength of their association with pancreatitis.
  • To emphasize the importance of considering drug etiology when other causes are excluded.

Main Methods:

  • Literature review of reported cases and associations between drug use and pancreatitis.
  • Categorization of implicated drugs into definite, probable, and questionable associations.
  • Analysis of proposed mechanisms for drug-induced pancreatitis.

Main Results:

  • Several drugs have a definite association with pancreatitis, including asparaginase, azathioprine, and didanosine.
  • Other agents show probable associations (e.g., corticosteroids, metronidazole) or questionable associations (e.g., acetaminophen, ketoprofen).
  • Proposed mechanisms involve duct constriction, cytotoxicity, hepatic involvement, and thrombosis.

Conclusions:

  • When ruling out common causes like alcohol abuse and biliary disease, drug-induced pancreatitis should be investigated.
  • Awareness of implicated medications is vital for clinicians to prevent and manage this adverse drug reaction.
  • Further research into mechanisms may improve diagnostic and therapeutic strategies.

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