Session 1

Assignment: What medication causes Pancreatitis? 

Considering the small number of patients who develop pancreatitis compared to the relatively large number who receive potentially toxic drugs, drug-induced pancreatitis is a relatively rare occurrence (accounting for approximately 2% of cases) that is probably related to an unknown predisposition. Fortunately, drug-induced pancreatitis is usually mild.

Drugs definitely associated with acute pancreatitis include the following:

• Azathioprine:  immunosuppressive medication used in rheumatoid arthritis, granulomatosis with polyangiitis, Crohn’s disease, ulcerative colitis, systemic lupus erythematosus, and in kidney transplants to prevent rejection.

• Sulfonamides: most sulfonamides are antibiotics, but some are prescribed for treating ulcerative colitis

• Sulindac: NSAID used to reduce pain, swelling, and joint stiffness from arthritis. It is also used to treat arthritis of the spine, gouty arthritis, and shoulder bursitis/tendonitis

• Tetracycline: antibiotic used to treat a number of infections. This includes acne, cholera, brucellosis, plague, malaria, and syphilis.

• Valproic acid: used for the treatment of convulsions, migraines and bipolar disorder.

• Didanosine: HIV antiviral. It is used in combination with other medications as part of highly active antiretroviral therapy (HAART). It is of the reverse-transcriptase inhibitor class.

• Methyldopa: antihypertensive

• Estrogens– Pancreatitis associated with use of estrogens is usually the result of drug-induced hypertriglyceridemia. The mechanisms involved in the case of other drugs are unknown. (Access medicine)

• Furosemide (Lasix): a loop diuretic (water pill) that prevents your body from absorbing too much salt. This allows the salt to instead be passed in your urine

• 6-Mercaptopurine: medication used for cancer and autoimmune diseases, immunosuppressant. Its prodrug is azothioprine

• Pentamidine: an antifungal medication that fights infections caused by fungus. Pentamidine is used to prevent and treat pneumonia caused by Pneumocystis jiroveci (carinii)

• 5-aminosalicylic acid compounds: drugs are frequently used for the treatment of mild to moderate acute inflammatory bowel disease (IBD)

• Corticosteroids

• Octreotide: (brand name Sandostatin, among others) is an octapeptide that mimics natural somatostatin pharmacologically, though it is a more potent inhibitor of growth hormone, glucagon, and insulin than the natural hormone.

• Thiazides

Source 1: https://www.medscape.com/answers/181364-14282/which-drugs-can-cause-acute-pancreatitis

Source 2:

Principles and Practice of Hospital Medicine, 2e > Acute Pancreatitis

TABLE 157-2 Drug-Induced Pancreatitis

Class I Medications: Case reports of acute pancreatitis with at least one documented case following re-exposure.

Class II Medications: Case reports of acute pancreatitis with consistent latency.

 

Session 2:

Pneumothorax vs. Hemothorax

Discussed Pneumothorax page in PPP and https://www.ncbi.nlm.nih.gov/books/NBK538219/

 

Session 3:

Blackboard Assignment on Erythema Multiforme vs. SJS vs. TEN