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. 1987 Apr;62(4):349–356. doi: 10.1136/adc.62.4.349

Influence of antacid and formulation on effectiveness of pancreatic enzyme supplementation in cystic fibrosis.

C Braggion, G Borgo, P Faggionato, G Mastella
PMCID: PMC1778352  PMID: 3036018

Abstract

A series of treatment trials, involving food balances based on determination of fat coefficient absorption, nitrogen faecal loss, and daily faecal weight, was performed in 82 patients with cystic fibrosis. Results showed that a conventional powdered pancreatic extract (Pancrex V) required a high dosage to achieve reasonable improvement in fat and nitrogen absorption (200 mg/kg body weight/day on average) and rarely restored digestion to normal. Bicarbonate (5.2 g/m2 body surface/day) slightly enhanced the enzymatic activity of the powdered extract, this being more apparent in those with more severe steatorrhoea. There was no advantage in providing the extract in microgranules protected by cellulose acetatephthalate. A product based on fungal lipase and protease (Krebsilasi) proved to be ineffective in correcting fat and protein absorption. The two recent products prepared in pH sensitive microspheres (Pancrex V microspheres and Pancreas-Prolipase) had similar advantages in digestive activity. Compared with the traditional preparations, they offered a number of practical advantages, including a smaller number of capsules (particularly Pancrex V microspheres) and improved palatability.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boyle B. J., Long W. B., Balistreri W. F., Widzer S. J., Huang N. Effect of cimetidine and pancreatic enzymes on serum and fecal bile acids and fat absorption in cystic fibrosis. Gastroenterology. 1980 May;78(5 Pt 1):950–953. [PubMed] [Google Scholar]
  2. Cho Y. W., Aviado D. M. Clinical pharmacology for pediatricians. I. Pancreatic enzyme preparations, with special reference to enterically coated microspheres of pancrelipase. J Clin Pharmacol. 1981 May-Jun;21(5-6):224–237. doi: 10.1002/j.1552-4604.1981.tb02552.x. [DOI] [PubMed] [Google Scholar]
  3. Cox K. L., Isenberg J. N., Osher A. B., Dooley R. R. The effect of cimetidine on maldigestion in cystic fibrosis. J Pediatr. 1979 Mar;94(3):488–492. doi: 10.1016/s0022-3476(79)80609-5. [DOI] [PubMed] [Google Scholar]
  4. DiMagno E. P., Malagelada J. R., Go V. L., Moertel C. G. Fate of orally ingested enzymes in pancreatic insufficiency. Comparison of two dosage schedules. N Engl J Med. 1977 Jun 9;296(23):1318–1322. doi: 10.1056/NEJM197706092962304. [DOI] [PubMed] [Google Scholar]
  5. Durie P. R., Newth C. J., Forstner G. G., Gall D. G. Malabsorption of medium-chain triglycerides in infants with cystic fibrosis: correction with pancreatic enzyme supplement. J Pediatr. 1980 May;96(5):862–864. doi: 10.1016/s0022-3476(80)80559-2. [DOI] [PubMed] [Google Scholar]
  6. Fredrikzon B., Bläckberg L. Lingual lipase: an important lipase in the digestion of dietary lipids in cystic fibrosis? Pediatr Res. 1980 Dec;14(12):1387–1390. doi: 10.1203/00006450-198012000-00026. [DOI] [PubMed] [Google Scholar]
  7. Gow R., Bradbear R., Francis P., Shepherd R. Comparative study of varying regimens to improve steatorrhoea and creatorrhoea in cystic fibrosis: Effectiveness of an enteric-coated preparation with and without antacids and cimetidine. Lancet. 1981 Nov 14;2(8255):1071–1074. doi: 10.1016/s0140-6736(81)91276-9. [DOI] [PubMed] [Google Scholar]
  8. Graham D. Y. An enteric-coated pancreatic enzyme preparation that works. Dig Dis Sci. 1979 Dec;24(12):906–909. doi: 10.1007/BF01311943. [DOI] [PubMed] [Google Scholar]
  9. Jeejeebhoy K. N., Ahmad S., Kozak G. Determination of fecal fats containing both medium and long chain triglycerides and fatty acids. Clin Biochem. 1970 Jun;3(2):157–163. [PubMed] [Google Scholar]
  10. Mischler E. H., Parrell S., Farrell P. M., Odell G. B. Comparison of effectiveness of pancreatic enzyme preparations in cystic fibrosis. Am J Dis Child. 1982 Dec;136(12):1060–1063. doi: 10.1001/archpedi.1982.03970480026006. [DOI] [PubMed] [Google Scholar]
  11. Nassif E. G., Younoszai M. K., Weinberger M. M., Nassif C. M. Comparative effects of antacids, enteric coating, and bile salts on the efficacy of oral pancreatic enzyme therapy in cystic fibrosis. J Pediatr. 1981 Feb;98(2):320–323. doi: 10.1016/s0022-3476(81)80671-3. [DOI] [PubMed] [Google Scholar]
  12. Pointner H., Flegel U. Die Behandlung der exokrinin Pankreasinsuffizienz mit einer säurestabllen Pilzlipase. Arzneimittelforschung. 1975 Nov;25(11):1833–1835. [PubMed] [Google Scholar]
  13. Roy C. C., Weber A. M., Morin C. L., Combes J. C., Nusslé D., Mégevand A., Lasalle R. Abnormal biliary lipid composition in cystic fibrosis. Effect of pancreatic enzymes. N Engl J Med. 1977 Dec 15;297(24):1301–1305. doi: 10.1056/NEJM197712152972401. [DOI] [PubMed] [Google Scholar]
  14. Warwick W. J., Budd J. R. Comparison of two forms of enteric-coated pancrelipase In six teenagers with cystic fibrosis. Clin Ther. 1982;5(1):15–20. [PubMed] [Google Scholar]

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