Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: KEGG:D00446 (Sucralfate)
 278 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peristomal and perineal excoriation commonly occurs despite preventive measures. Drainage from around gastrostomy tubes or ongoing perineal soilage after a pull-through procedure can lead to chemical irritation, cutaneous denudation, and chronic discomfort. A multitude of topical agents have been tried with variable results. We present our experience using topical sucralfate. Fifteen patients with stomal or perineal skin ulceration were treated with topical sucralfate only after other agents had failed. Clinical photographs were obtained first. Sucralfate, prepared as either a powder or an emollient, was liberally applied to the affected area during diaper changes or when the stomal appliance was emptied. For tube gastrostomy sites, sucralfate was applied every 4 to 6 hours as required to maintain a visible layer. In 13 patients, complete healing occurred. Recovery time was dependent on the severity and extent of skin denudation. Partial healing occurred in one patient. In another patient, the skin excoriation healed but a residual candidal rash required addition of an antifungal agent. General observations included: (1) a lag time of 2 to 3 days before visible healing was evident; (2) healing occurred from the perimeter; (3) sucralfate was soothing and reduced discomfort; (4) it was ineffective for fungal dermatitis; and (5) sucralfate did not appear to have toxic or systemic effects. Topically applied sucralfate is soothing, safe, and effective.
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PMID:Topical sucralfate: effective therapy for the management of resistant peristomal and perineal excoriation. 181 56

In the United States, the drugs most commonly used to treat peptic ulcer disease are antacids and the H2-receptor antagonists cimetidine and ranitidine. Other available agents include anticholinergics and the coating agent sucralfate. Investigational drugs such as colloidal bismuth, carbenoxolone, prostaglandins, the tricyclic compound pirenzepine, and substituted benzimidazoles are not available for use in the United States. Most of the commercially available and investigational compounds have similar efficacy; therefore the optimal drug may be the one associated with the fewest adverse effects and the most convenient dosing regimen. Cimetidine causes a small number of adverse effects, including neuropsychiatric disorders, gynecomastia, impotence, loss of libido, elevation of serum creatinine and serum transaminases concentrations, and drug interactions. Some of these reactions have been of clinical significance. Presently, there are rare reports of gynecomastia, bradycardia, inhibition of acetylcholinesterase, headache, lethargy, diarrhea, and rash in patients receiving ranitidine. Antacids can produce either diarrhea or constipation and have been associated with low serum phosphorus concentrations, and metabolic alkalosis. Anticholinergics, especially in elderly or debilitated patients, can cause central nervous system disorders, intestinal atony, or urinary retention. Sucralfate may cause constipation, diarrhea, nausea, and headache. The investigational agents have their own side effect profiles. The adverse effects of anticholinergics make them unattractive therapeutic choices, and antacids and sucralfate have inconvenient dosing requirements compared with some equally efficacious alternatives. In addition, clinical experience with sucralfate in the United States is limited. The safety record of cimetidine is admirable. As clinical experience with ranitidine increases, currently unrecognized adverse effects may be reported. However, based on current data, ranitidine is as effective as cimetidine and is associated with a lower incidence of side effects.
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PMID:Problems associated with medical treatment of peptic ulcer disease. 609 62