在肝硬化患者中使用纳尔特雷的安全性
Rachel Thompson1, Tamar Taddei2,3, David Kaplan4,5
1Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
JHEP reports : innovation in hepatology
|July 4, 2024
概括
纳尔特雷对于肝硬化和酒精使用障碍患者是安全的. 这项研究没有发现药物诱导的肝损伤 (DILI) 在肝硬化患者处方纳尔德,鼓励在这个人群中使用它.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 成 药物 药物 药物 药物
背景情况:
- 酒精使用障碍 (AUD) 治疗改善了酒精相关肝硬化患者的生存率.
- 由于对药物诱导性肝损伤 (DILI) 的担忧,AUD的药物在这个人群中未得到充分利用.
研究的目的:
- 评估纳尔特雷在肝硬化患者中的安全性.
- 评估开始纳尔特雷克森治疗的肝硬化患者中DILI的风险.
主要方法:
- 使用VOCAL数据库对患有肝硬化的患者进行了回顾性研究.
- 包括在3个月内新启动纳尔特雷克松的肝硬化后诊断和肝酶测试的患者.
- 使用罗塞尔·乌克拉夫因果关系评估方法 (RUCAM) 来评估DILI.
主要成果:
- 3,285名肝硬化患者开始服用纳尔特雷克松;2,940人进行了实验室检测.
- 只有2%的患者经历了肝酶升高.
- 没有确定可能,可能或极可能的DILI病例;没有因纳尔特雷而导致的死亡或失效.
结论:
- 在肝硬化患者中,纳尔特雷克松的启动与DILI无关.
- 纳尔特雷似乎对补偿和失补偿性肝硬化患者安全.
- 研究结果可能会鼓励在患有肝病和AUD的患者中更广泛地使用纳尔特雷.
相关概念视频
Esophageal Varices-II: Clinical Features and Management
57
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
57
CNS Depressants: Alcohol and Nicotine
201
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
201
Diseases of the Liver and Gallbladder
507
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
507
Drugs for Treatment of Constipation-Predominant IBS
154
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
154
Hepatic Drug Excretion: Enterohepatic Cycling
1.5K
Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
1.5K
Factors Influencing Drug Absorption: Disease States and Pharmacology
489
Multiple disease states can significantly influence the oral drug absorption process by affecting blood flow and the functionality of the gastrointestinal (GI) system. Various GI diseases, including conditions that alter GI motility, such as diarrhea, decreased acid secretions (achlorhydria), and infections, have been associated with reduced drug absorption.
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
489


