Cholestyramin

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). 

Because colestipol and cholestyramine are not absorbed, but simply pass through the body by the GI tract, few severe side effects occur. Patients often complain of distaste and constipation, however. More severe side effects such as GI bleeding ate relatively uncommon (151). 

Anion exchange resins are basic polymers with a high affinity for anions. Because different anions compete for binding to them, they can be used to sequester anions. Clinically used anion exchange resins such as cholestyramine are used to sequester bile acids in the intestine, thereby preventing their reabsorption. As a consequence, the absorption of exogenous cholesterol is decreased. The accompanying increase in low density lipoprotein (LDL)-receptors leads to the removal of LDL from the blood and, thereby, to a reduction of LDL cholesterol. This effect underlies the use of cholestyramine in the treatment of hyperlipidaemia. 

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

Cholestyramine powder The prescribed dose must be mixed in 4 to 6 duid ounces of water or noncar-bonated beverage and shaken vigorously. The powder can also be mixed widi highly fluid soups or pulpy fruits (applesauce crushed pineapple). The powder should not be ingested in die dry form. 

Odier dragp are taken 1 hour before or 4 to 6 hours after cholestyramine Cholestyramine is available combined widi die artificial sweetener, aspartame (Questran Light), for patients widi diabetes or diose who are concerned with weight gain. 

A patient in the medical clinic is taking cholestyramine (Questran) for hyperlipidemia. The primary health care provider has prescribed TLC for the patient. The patient is on a low-fat diet and walks daily for exercise. His major complaint at this visit is constipation, which is very bothersome to him. Discuss how you would approach this situation with the patient. What information would you give the patient concerning his constipation ... 

When administered with cholestyramine or colestipol there is a decreased absorption of the oral thyroid preparations. These drugs should not be administered within 4 of 6 hours of the thyroid hormones. When administered with the oral anticoagulants there is an increased risk of bleeding. It may be advantageous to decrease the dosage of the anticoagulant when a thyroid preparation is prescribed. There is a decreased effectiveness of the digitalis preparation if taken with a thyroid preparation. 

The only relevant information located was that administration of cholestyramine resin may increase fecal excretion of endosulfan trapped in the enterohepatic circulation (Dreisbach and Robertson 1987 Howland 1990 HSDB 1999). 

Oster G, Epstein AM. Cost-effectiveness of antihyperlipemic therapy in the prevention of coronary heart disease. The case of cholestyramine. JAMA 1987 258 2381-7. 

Cholestyramine 4 g packets 4-24 g/day in two or more divided doses Main side effects are nausea, constipation, bloating, and flatulence, although these may be less with... 

Cholestyramine, colestipol, and colesevelam are the bile acidbinding resins or sequestrants (BAS) currently available in the United States. Resins are highly charged molecules that bind to bile adds (which are produced from cholesterol) in the gut. The resin-bile acid complex is then excreted in the feces. The loss of bile causes a compensatory conversion of hepatic cholesterol to bile, reducing hepatocellular stores of cholesterol resulting in an up-regulation of LDL receptors to replenish hepatocellular stores which then result in a decrease in serum cholesterol. Resins have been shown to reduce CHD events in patients without CHD.26... 

Patients who have had multiple intestinal resections due to CD may have diarrhea related to the inability to reabsorb bile salts. Cholestyramine has been demonstrated to improve diarrheal symptoms in this population.8,15 NSAIDs should be avoided for pain management due to their ability to worsen IBD symptoms. Narcotic analgesics should be used with caution, as they may significantly reduce GI motility. 

Diarrhea may occur from effects of chemotherapy on the lower portion of the GI tract. Diarrhea can be severe and may need to be treated with intravenous fluids and electrolytes. Infectious causes, such as C. difficile, should be ruled out. Pharmacologic therapy of diarrhea can range from loperamide or cholestyramine to octreotide for severe cases of diarrhea that are refractory to usual treatments. 

Association to cholestyramine, and sucralfate Inhibition of digestive absorption... 

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