Bile-acid binding resins

Bile Acid Sequestrants. The bile acid binding resins, colestipol [26658424] and cholestyramine, ate also effective in controlling semm cholesterol levels (150). Cholestyramine, a polymer having mol wt > ICf, is an anion-exchange resin. It is not absorbed in the gastrointestinal tract, is not affected by digestive enzymes, and is taken orally after being suspended in water (151). 

Hyperlipidemia. Bile acid binding resins such as cholestyramine sequester bile acids in the intestine,... 

The answer is c. (Hardman, pp 887, 889.) Bile acid-binding resins bind more than just bile acids, and binding of simvastatin to cholestyramine is the most likely mechanism for decreased Gl absorption. Cholestyramine may also bind to several other drugs, including digoxin, benzothiadiazides (thiazides), warfarin, vancomycin, thyroxine (T4), and aspirin. Medications should be given one hour before or four hours after cholestyramine. 

Concomitant lipid-lowering f/ erapy-Atorvastatin may be used in combination with a bile-acid-binding resin for additive effect. Generally, avoid the combination of HMG-CoA reductase inhibitors and fibrates. 

Concomitant lipid-lowering therapy-The effect of rosuvastatin on LDL-C and total-C may be enhanced when used in combination with a bile acid-binding resin. If rosuvastatin is used in combination with gemfibrozil, limit the dose of rosuvastatin to 10 mg once daily. 

In addition symptomatic treatment with opiates, with bile acid binding resins in those with bile acid malabsorption, with milk free diets in those who are lactose intolerant, and with low fat diets may materially help relevant symptoms. 

Biliary cirrhosis, secondary disease this requires elimination of the obstructive cause. Itching associated with bile acid retention can respond to cholestyramine, a bile acid binding resin. 

Itching associated with retention of bile acids is ameliorated by treatment with the bile acid binding resin cholestyramine. Fat soluble vitamin (A, D and K) deficiency may require administration of supplements. Direct toxic effects of alcohol associated with dietary deficiency may require soluble B vitamin administration. 

FIBRIC ACID DERIVATIVES BILE ACID-BINDING RESINS... 

Colestimide (colestilan)2 Bile acid binding resin improves glycemic control and reduces weight in an obese DM-2 model... 

See also Antacids Bile acid-binding resins. 

Review of the use of HMG-CoA inhibitors and bile acid-binding resins to reduce serum cholesterol. 

Fibric Acid Derivatives Bile Acid-Binding Resins... 

Bile acid-binding Resins may bind with orally... 

Bile acid binding resins have been the mainstay of treatment for heterozygous FH for many years. Unfortunately they are not as effective as one might hope, because the liver partially compensates for the drain on cholesterol by increasing its own production of cholesterol from acetyl-CoA (B51, Dll). Two recently developed drugs, compactin (B50, E7) and mevinolin... 

There are four principal classes of lipid-lowering drugs used in the treatment of CAD (1) 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, (2) bile acid-binding resins, (3) nicotinic acid, and (4) fibric acid derivatives. 

The prototype of a bile acid-binding resin is cholestyramine. Cholestyramine is the chloride salt of a basic anion-exchange resin. Its mechanism of action involves exchanging its chloride ion for bile acids in the intestinal lumen. By binding these bile acids, cholestyramine prevents them from being reabsorbed and, hence, they are... 

B. Hyperlipidemic patient treated with bile acid binding resins... 

Therapeutic uses The bile acid binding resins are the drugs of choice (often in combination with diet or niacin) in treating Type lla and lib hyperlipidemias. [Note In those rare individuals who are homozygous for Type lla, that is, for whom functional LDL receptors are totally lacking, these drugs have little effect on plasma LDL levels.] Cholestyramine can also relieve pruritus caused by accumulation of bile acids in patients with biliary obstruction. 

Concomitant fibric acid derivatives, oral contraceptives, bile acid binding resins, and antacids may decrease ursodiol efficacy... 

HMC-CoA reductase (the "statins"), nicotinic acid, and bile-acid binding resins (cholestyramine). 

Therapy with nicotinic acid plus bile acid binding resin revealed improvements in the biochemical risk factors, and also proved to reduce the thickness of atberosderfjtic lesions (Blankcnhom et al., 1993). 

Bile-acid-binding resin results in an interruption of the eiiterohepatic circulation of bile salts and in their iitcreased excretion in the feces. This drug therapy can pnsduce a 20-25" decrease in plasma LDL-cholesterol. A side effect of cholestyramine is constipation, but this problem can be relieved by a high fiber diet. 

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