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Pharmacologic Therapy

  • Walter G. ParkEmail author
Chapter
  • 1.7k Downloads

Abstract

Current management of severe acute pancreatitis remains primarily supportive with no widely accepted pharmacological abortive therapy in clinical practice. The foundation for developing a promising drug begins with understanding the pathophysiology of acute pancreatitis, which will be briefly reviewed. Specifically, understanding the mechanisms of local and systemic inflammation triggered from acinar injury is important for severe disease. For several decades, various pharmacological agents for pancreatitis have been studied in randomized clinical trials with inconsistent results. These drugs can be categorized by their mechanism of action: anti-secretory agents, protease inhibitors, immunomodulators, antioxidants, and anti-inflammatory agents. Relevant trials will be reviewed and summarized followed by a discussion of future therapeutic opportunities. Such future therapies may come from better understanding and appreciation of the role of the immune system in controlling disease activity. Important strategic steps necessary for developing an effective pharmacological agent for severe acute pancreatitis should focus on reconciling differences between preclinical studies and human clinical trials and standardizing eligibility and outcomes in future clinical trials. Future clinical trials should emphasize more rapid randomization and delivery of medication for earlier interruption of the inflammatory cascade responsible for the significant morbidity and mortality of this disease.

Keywords

Acute Pancreatitis Acinar Cell Systemic Inflammatory Response Syndrome Severe Acute Pancreatitis Mortality Benefit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Departments of Medicine and GastroenterologyStanford University Medical CenterStanfordUSA
  2. 2.Pancreas Clinic, Stanford UniversityStanfordUSA

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