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Pancreatitis—Chronic
Published in Charles Theisler, Adjuvant Medical Care, 2023
Pancreatic enzyme supplementation is warranted.6 Enteric-coated pancreatic enzymes are utilized for replacement of pancreatic function. Because of its higher enzyme content, pancrelipase formulations are favored over pancreatin preparations.7
Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Pancreatic cancers are considered to be unresectable when they are diagnosed, due to metastases. Based on tumor location, surgery is performed. External beam radiation therapy is often used. Chemotherapy and radiation combinations may be also used. If there are liver or distant metastases, chemotherapy may be used. For moderate to severe pain, oral opioids are administered. Pain control is more important than any concern about addiction. Long-acting preparations are good for chronic pain, and include transdermal oxymorphone, oxycodone, or fentanyl. Exocrine pancreatic insufficiency is treated with oral pancrelipase. Dosage is based on symptoms, the amount of steatorrhea, and dietary fat content. Proton pump inhibitors or H2-blockers may also be required. If diabetes mellitus is present, it must be monitored and controlled with care.
Protein drug delivery: current dosage form profile and formulation strategies
Published in Journal of Drug Targeting, 2020
Danilo Costa Geraldes, Viviane Lucia Beraldo-de-Araújo, Boris Odelion Pichihua Pardo, Adalberto Pessoa Junior, Marco Antônio Stephano, Laura de Oliveira-Nascimento
According to the databank, 97% of commercial protein drugs are administered by parenteral routes, which comprises the intravenous, subcutaneous, intramuscular, intraocular and intraventricular ones. The remaining 3% consists of topical, respiratory and oral routes. The protein-drug profile contrasts with chemical-based drugs, for which the most common route of administration is through orally administered pills [38]. The discrepancy relies on the fact that protein drugs usually have poor oral bioavailability [39,40]. In addition to the pH shifts, molecule viability may reduce due to hydrolytic enzymes or microbiota interaction. Barrier crossing for large molecules is not favoured by their size, which imposes a physical restraint for mucus and mucosal penetration [41]. Therefore, only the group of enzymes named pancrelipase and sacrosidase is formulated for oral delivery in our list (capsules containing enteric-coated spheres); both are intended for local action and protected from the acidic environment by the formulation.
Development of a novel oral complex lipid emulsion containing triptolide for targeting pancreatic cancer
Published in Pharmaceutical Development and Technology, 2022
Liangyu Mu, Peiyao Wu, Ying Zhang, Shiqi Li, Rui Yang, ShuJun Wang
Biodistribution studies in mice following oral administration of TP/DG-CLEs revealed rapid accumulation of TP in brain, kidney, lung, heart, and spleen tissue 30 min after dosing with the highest concentration in the pancreas and liver. Notably, the TP/DG-CLE (1:22.5) formulation resulted in the highest accumulation in the pancreas at 1 h combined with a marked (70%) decrease in concentration in the liver at 30 min, indicating a pancreas targeting capacity. Since the drug was loaded in the oil phase or in the oil–water interfacial film, this structure might be absorbed into the pancreas and metabolised by pancrelipase, providing some explanation for the anti-pancreatic cancer activity of the compound.
Albumin-Globulin Ratio Indicates the Survival Outcome of Pancreatic Cancer Cases Who Underwent Preoperative Treatment and Curative Surgical Resection
Published in Nutrition and Cancer, 2023
Masamichi Hayashi, Daigo Kobayashi, Hideki Takami, Yoshikuni Inokawa, Nobutake Tanaka, Keisuke Kurimoto, Koki Nakanishi, Shinichi Umeda, Dai Shimizu, Norifumi Hattori, Mitsuro Kanda, Chie Tanaka, Goro Nakayama, Yasuhiro Kodera
Conversely, cases without preoperative therapy showed no advantage of high AGR in their survival outcomes (Supplementary Fig. S3). It also supports the hypothesis that the AGR index may reflect the patient’s tolerance to preoperative therapy, a current standard strategy of PDAC treatment. Moreover, both nutritional support by pancrelipase tablets or amino acid-rich nutrients and intensive infection control arising from cholangitis or duodenal stenosis before preoperative therapy may improve the ARDI of preoperative therapy and prolong the survival outcomes.