Cholestyramine application

Interferes w/ DNA synth Dose Adults. Anaerobic Infxns 500 mg IV q6-8h Amebic dysentery 750 mg/d PO for 5-10 d Trichomoniasis 250 mg PO tid for 7 d or 2 g PO X 1 C. difficile 500 mg PO or IV qSh for 7-10 d (PO preferred IV only if pt NPO) Vaginosis 1 applicator-full intravag bid or 500 mg PO bid for 7 d Acne rosacea/skin Apply bid Peds. 30 mg/ kg PO/IV/d q6H, 4 g/d max-s-. Amebic dysentery 35-50 mg/kg/24 h PO in 3 -s- doses for 5-10 d Rx 7-10 d for C. difficile-, in hepatic impair Caution [B, M] Avoid EtOH Contra 1st tri of PRO Disp Tabs, caps, IV, topical lotion, intravag gel, cream SE Disulfiram-like Rxn dizziness, HA, GI upset, anorexia, urine discoloration Interactions t Effects W/ cimetidine T effects OF carbamazepine, fluorouracil, Li, warfarin -1- effects W/ barbiturates, cholestyramine, colestipol, phenytoin EMS t Effects of anticoagulants concurrent EtOH use can cause disulfiram-like Rxn (tach, N/V, sweating, flushing, headache, blurred vision, confusion) may cause a metallic taste and discolored urine OD May cause N/V/D, numbness in hands and feet, Szs, and loss of coordination symptomatic and supportive... 

Cholestyramine may prove necessary for severe pruritus due to a cholestatic course of disease (4-8 g prior to breakfast) - if antihistamines were unsuccessful. With such a cholestatic course of disease, the application of ursodeoxycholic acid (2-3 x 250 mg) is most suitable. (166) In some cases with a fulminant course, interferon alpha has been successfully used. Special diets , glucocorticoids or other medication are not necessary. 

An interesting application of this interaction is seen with the use of leflunomide (Arava) in the treatment of rheumatoid arthritis. Leflunomide can cause fetal harm if administered during pregnancy, and it has an active metabolite that can persist in the system for at least 2 years. If a woman of childbearing potential discontinues use of leflunomide, it is recommended that cholestyramine (8 g 3 times a day for 11 days) be used to accelerate the elimination of the drug and its active metabolite. 

Chitosan is known to have a significant hypocholesterolemic activity in various experimental animals. Chitosan has been tested for reducing cholesterol, it has lipid-lowering effects similar to those of cholestyramine and has been used in clinical application. 

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