Niacin therapy

Potentially important laboratory abnormalities occurring with niacin therapy include elevated liver function tests, hyperuricemia, and hyperglycemia. Niacin-associated hepatitis is more common with sustained-release preparations, and their use should be restricted to patients intolerant of regular-release products. Niacin is contraindicated in patients with active liver disease, and it may exacerbate preexisting gout and diabetes. 

Miller SM. Potential perils of niacin therapy. Clin Lab Sci 1991 4 156-8. 

Luria MH. Atherosclerosis the importance of HDL cholesterol and prostacyclin a role for niacin therapy. Med Hypotheses 1990 32(l) 21-8. 

Pasternak RC, Kolman BS. Unstable myocardial ischemia after the initiation of niacin therapy. Am J Cardiol 1991 67(9) 904-6. 

Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Intern Med... 

Leighton RF, Gordon NF, Small GS, Davis WJ, Ward ES Jr. Dental and gingival pain as side effects of niacin therapy. Chest 1998 114 1472-4. 

Kristensen T, Olcott EW. Effects of niacin therapy that simulate neoplasia Hepatic steatosis with concurrent hepatic dysfunction. J Comput Assisted Tomogr 1999 23 314-7. 

Adverse effects The most common side effects of niacin therapy are an intense cutaneous flush (accompanied by an UnCOmfOrt-... 

Auricchio et al. (A12) analyzed the excretory pattern of 6 children with leukemia and 2 with Hodgkin s disease. No definite relationship could be observed between the disease and the abnormally elevated amounts of tryptophan metabolites. After niacin therapy the urinary excretion of kynurenines and kynurenic and xanthurenic acids was normalized in one case of Hodgkin s disease and in one leukemic subject after pyridoxine administration. 

Blankenhnrn, D. H-, Selzer, R. H., Crawford, D., Barth,)., liu, C., Mack, M., and Alaupovic, P (1993). Beneficial effects of colestipol-niacin therapy on the common carotid artery. CirictffBfjetT BS, 20-28. 

Fraunfelder FW, Fraunfelder FT, Illingworth DR. Adverse ocular effects associated with niacin therapy. Br J Ophthalmol 1995 79(l) 54-6. 

Blankenhorn DH, Nessim SA, Johnson RL, Sanmarco ME, Azen SP, Cashin-HemphiU L. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA 1987 257 3233-40. 

Why might niacin therapy be contraindicated in a type II diabetic patient ... 

Explain the contraindication to niacin therapy in patients with gout. 

Earthman TP, Odom L, Mullins CA. Lactic acidosis associated with high-dose niacin therapy. Sou iMedJ( 99 ) 84, 496-7. 

A. Hoffo, Niacin Therapy in Psychiatry (Thomas, Springfield, III., 1962). 

Tavella M, Alaupovic P, Blankenhom D, Chin HP (1987) Specific effect of combined colestipol and niacin therapy on apoUpoprotein B-containing particles. Arteriosclerosis 7 494a... 

The earliest neurologic symptoms of pellagra are reminiscent of neurasthenia, with insomnia, fatigue, nervousness, irritability, and depression with memory loss (Victor et al, 1971). A progressive dementia can develop, but this seems unlikely to be caused solely by the absence of niacin. An acute confusional syndrome also occurs in human pellagra, and this is reversible with niacin therapy. A central neuritis is prominent in the large motor cortex cells (the Betz cells). This is not a demyelinating process like Bj2 deficiency but a primary involvement of the whole neuron. 

Duggal, J.K., Singh, M., Attri, N., Singh, P.P., Ahmed, N., Pahwa, S., Molnar, J., Singh, S., Khosla, S., and Arora, R., 2010. Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease. Journal of Cardiovascular Pharmacology and Therapeutics. 15 158-166. 

Fischer, D.J., Knight, L.L., and Vestal, R.E., 1991. Fulminant hepatic failure following low-dose sustained-release niacin therapy in hospital. The Western Journal of Medicine. 155 410-412. 

Guyton, J.R., and Bays, H.E.,2007. Safety considerations with niacin therapy. American Journal of Cardiology. 99 S22-S31. 

Blankenhom DH, Azen SP, Crawford DW, Nessim SA, et al. Effects of colestipol-niacin therapy on human femoral atherosclerosis. Circulation 1991 83 438-447. 

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