Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The lipoprotein lowering effect of gemfibrozil, 400 mg twice daily, was studied for 24 weeks in 26 subjects with primary hyperlipoproteinaemia (type IIa, 5; IIb, 3; III, 3; and IV, 15). Maximum effects were noted after four weeks on very low density lipoproteins (VLDL) and after 12 weeks on low density lipoproteins (LDL), these effects remaining throughout the study. Gemfibrozil decreased VLDL triglycerides (TG) in all types of hyperlipoproteinaemia according to the equation: deltaVLDL TG (mmol/l) = -0.80 X initial VLDL TG concentration + 0.68 The drug affected the low density lipoprotein (LDL) cholesterol= -0.45 X initial LDL cholesterol + 61 This means that LDL cholesterol on average decreased if the initial LDL concentration was above 135 mg/100 ml and increased below that concentration. LDL TG and high density lipoprotein (HDL) TG concentrations also decreased significantly. A slight increase in HDL cholesterol concentration occurred after administration of gemfibrozil. Two subjects had to stop treatment because of nausea and abdominal pain respectively, attributed to the drug. No biochemical side effects were noted.
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PMID:Effect of gemfibrozil on lipoprotein concentrations in different types of hyperlipoproteinaemia. 19 Jun 7

Fibric acid derivatives (FADs) are a class of drugs that have been shown to reduce the production of very low-density lipoprotein (VLDL) while enhancing VLDL clearance due to the stimulation of lipoprotein lipase activity. The drugs can reduce plasma triglyceride levels while raising high-density lipoprotein (HDL) cholesterol levels. Their effects on low-density lipoprotein (LDL) cholesterol levels are less marked and more variable. There is evidence that oral gemfibrozil (Lopid, Parke-Davis, Morris Plains, NJ) can reduce the risk of serious coronary events, specifically in those patients who had elevations of both LDL cholesterol levels and total plasma triglyceride levels with lower HDL cholesterol levels. Newer FADs (bezafibrate, ciprofibrate, fenofibrate) have been shown to have greater efficacy in reducing LDL cholesterol than gemfibrozil but, in general, these drugs are not as effective as the other primary drugs used to lower LDL levels. The FADs are also used to treat adult patients with very high levels of triglycerides who have pancreatitis and whose disease cannot be managed with dietary therapy. The FADs are well tolerated, with dyspepsia and abdominal pain the most common adverse effects. A small risk of cholelithiasis exists with these drugs, and caution should be used when combining these drugs with HMG-CoA reductase inhibitors because the combination increases the incidence of hyperlipidemic myositis and rhabdomyolysis.
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PMID:Effects of gemfibrozil and other fibric acid derivatives on blood lipids and lipoproteins. 204 26

The long term use of lipid-lowering drugs in the treatment of patients with hyperlipoproteinaemia is aimed at reducing plasma concentrations of known atherogenic lipoproteins with a favourable effect on lipid deposition in the arterial wall. A less common aim is to prevent the adverse sequelae of hyperchylomicronaemia in patients with severe hypertriglyceridaemia. The decision to begin drug therapy should be made only after the exclusion of secondary factors and after an adequate trial of diet has failed to produce acceptable concentrations of plasma lipids and lipoproteins. The bile acid sequestrants (cholestyramine and colestipol), nicotinic acid, fenofibrate and inhibitors of hydroxymethylglutaryl coenzyme A (HMG CoA) reductase (e.g. lovastatin or simvastatin) are the most effective drugs for use in patients with primary hypercholesterolaemia; these agents reduce plasma concentrations of total and LDL-cholesterol by 15 to 45%. For those patients with concurrent hypertriglyceridaemia, nicotinic acid, lovastatin or simvastatin, or fenofibrate are the preferred drugs for initial use; bile acid sequestrants frequently exacerbate hypertriglyceridaemia in these patients. Fibric acid derivatives (e.g. clofibrate, gemfibrozil, bezafibrate or fenofibrate) are all effective in the therapy of patients with type III hyperlipoproteinaemia, as is nicotinic acid and I have found lovastatin to be effective also. Gemfibrozil or nicotinic acid are the most effective agents to use in the treatment of patients with severe hypertriglyceridaemia who are at increased risk of abdominal pain and pancreatitis. Combined therapy with drugs which have different mechanisms of action can be effectively used in the treatment of patients with severe hypercholesterolaemia or combined hyperlipidaemia; for the former group, combinations which use bile acid sequestrants, HMG CoA reductase inhibitors and nicotinic acid are the most effective.
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PMID:An overview of lipid-lowering drugs. 307 24

Analysis of the efficacy and tolerability of gemfibrozil (Gevilon-Parke Davis) was performed including 29 patients aged 19-69 years with primary hyperlipoproteinemia (HLP) type IIb-16 persons, IV-13 persons. All patients got dietary recommendations and received gemfibrozil 450-900 mg/day for 3 months. In both types of HLP a significant reduction of serum cholesterol (TCh)--15.5% triglycerides (TG)--32.1% VLDL-Ch--34.9% and VLDL-TG concentration--36.6% was observed as well as an increase of HDL3 fraction-16.3%. The greatest reduction of serum TCh concentration and VLDL-Ch were observed in type IIb, while that of TG and VLDL-TG in type IV HLP. The best therapeutic effect was obtained during the first month of treatment. The percent of TCh, TG, VLDL-Ch, VLDL-TG reduction correlated with their initial level. Tolerability of gemfibrozil was very good. Only in 2 patients transient abdominal pain was observed.
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PMID:[Evaluation of the efficiency of gemfibrozil in treating hyperlipidemia type IIb and IV]. 819 Jun 59

Our specific aim was to assess severe hypertriglyceridemia and pancreatitis that occurred when postmenopausal estrogen replacement therapy (ERT) or tamoxifen had been given by their physicians to women with preexisting, usually covert, primary familial hypertriglyceridemia. We retrospectively studied 31 women referred for diagnosis and therapy of hypertriglyceridemia over 2.75 years whose initial visit fasting plasma triglyceride levels were > 750 mg/dl. Of the 31 women with hypertriglyceridemia, 12 (39%) had been given exogenous estrogen by their physicians (11 ERT, one tamoxifen). Ten of the 12 women, while undergoing ERT, had triglyceride levels > 1200 mg/dl. In triglyceride referral categories 750 to 1000, 1000-1500, and > 1500 mg/dl, 17% (2 of 12), 33% (3 of 9), and 70% (7 of 10), respectively, of the 31 women with hypertriglyceridemia were receiving ERT. The higher the triglycerides were at referral, the greater was the likelihood that women were taking ERT (x2 = 6.6, p = 0.035). Four of the seven women with triglyceride levels > 1500 mg/dl while undergoing ERT were hospitalized with severe acute pancreatitis; another two had severe abdominal pain thought to be pancreatic in origin. To quickly lower dangerously high triglyceride levels, ERT was stopped in all 12 women. Lopid (1.2 to 1.5 gm/day) was given to the seven women not already taking it, and four were also given omega-3 fatty acids (4 to 15 gm/day). Median plasma triglyceride level at the initial visit in the 12 women undergoing ERT was 1665 mg/dl.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Severe hypertriglyceridemia and pancreatitis when estrogen replacement therapy is given to hypertriglyceridemic women. 828 56