Acute Pancreatitis Medication

Updated: Jul 25, 2019
  • Author: Jeffrey C F Tang, MD; Chief Editor: BS Anand, MD  more...
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Medication

Medication Summary

The goal of pharmacotherapy is to relieve pain and minimize complications. Currently, no medications are used to treat acute pancreatitis specifically. Therapy is primarily supportive and involves intravenous (IV) fluid hydration, analgesics, antibiotics (in severe pancreatitis), and treatment of metabolic complications (eg, hyperglycemia and hypocalcemia).

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Analgesics, Other

Class Summary

Pain control is essential for quality patient care. It ensures patient comfort, promotes pulmonary toilet, and has sedating properties, which are beneficial for patients who have sustained trauma or have painful lesions. Propoxyphene products were withdrawn from the US market on November 19, 2010. The withdrawal was based on new data showing QT prolongation at therapeutic doses. For more information, see the FDA MedWatch safety information.

Acetaminophen (Tylenol, Feverall, Aspirin Free Anacin)

Acetaminophen is a peripherally acting drug of choice for mild to moderate pain and elevation of body temperature.

Tramadol (Ultram, Ryzolt, Rybix)

Tramadol is a centrally acting analgesic for moderately severe pain. It inhibits the ascending pain pathways, altering perception of and response to pain. It also inhibits reuptake of norepinephrine and serotonin.

Meperidine (Demerol)

Meperidine is a synthetic opioid narcotic analgesic for the relief of severe pain. It has multiple actions similar to those of morphine. It may produce less constipation, smooth muscle spasm, and depression of cough reflex than similar analgesic doses of morphine.

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Antibiotics, Other

Class Summary

Antibiotics are used to cover the microorganisms that may grow in biliary pancreatitis and acute necrotizing pancreatitis. The empiric antibiotic regimen is usually based on the premise that enteric anaerobic and aerobic gram-bacilli microorganisms are often the cause of pancreatic infections. Once culture sensitivities are obtained, the antibiotic regimen can be adjusted accordingly.

Imipenem and cilastatin (Primaxin)

Imipenem is a thienamycin derivative with greater potency and broader antimicrobial spectrum than other beta-lactam antibiotics. Cilastatin inhibits dehydropeptidase activity and reduces cilastatin metabolism. Imipenem-cilastatin is used for the treatment of multiple-organism infections in which other agents either do not provide wide-spectrum coverage or are contraindicated because of potential toxicity. The 2 agents are generally administered in a 1:1 ratio.

Ampicillin

Ampicillin has bactericidal activity against susceptible organisms. It is an alternative to amoxicillin when the patient is unable to take medication orally.

Ceftriaxone (Rocephin)

Ceftriaxone is a third-generation cephalosporin with broad-spectrum gram-negative activity; it has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms. Ceftriaxone arrests bacterial growth by binding to 1 or more penicillin-binding proteins.

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