Direct acting inhibitors of ammoniagenesis: a role in post-TIPS encephalopathy?
| Autor: | Stephen H. Caldwell, Winston A. Ally, Nitin K. Ahuja |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Encephalopathy Specialties of internal medicine Phenylacetate Phenylbutyrate chemistry.chemical_compound Ammonia Internal medicine medicine Glycerol phenylbutyrate Intensive care medicine Hepatic encephalopathy Urea metabolism Hepatology business.industry Sodium phenylbutyrate General Medicine medicine.disease Endocrinology chemistry RC581-951 Urea cycle TIPS business Transjugular intrahepatic portosystemic shunt medicine.drug |
| Zdroj: | Annals of Hepatology, Vol 13, Iss 2, Pp 179-186 (2014) |
| ISSN: | 1665-2681 |
| Popis: | A limited number of medications are typically considered for the management of hepatic encephalopathy occurring as a complication of transjugular intrahepatic portosystemic shunt (TIPS) placement. Multiple alternative compounds aimed at disrupting ammoniagenesis are or will soon be available, though their use tends to be limited by a lack of large data sets and of clinical awareness. In this review, we provide a targeted overview of the mechanisms and availability of five anti-ammoniagenic compounds (sodium phenylbutyrate, glycerol phenylbutyrate, sodium benzoate, L-ornithine L-aspartate, and ornithine phenylacetate) identified as possibly useful alternative therapeutic agents for cirrhotic encephalopathy. Three of these medications have been FDA approved for use in congenital urea cycle disorders only, while two are under active investigation for use in cirrhotic patients. In spite of limitations posed by cost and comorbidities, familiarity with these options may prove beneficial in cases refractory to conventional management. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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