Direct acting inhibitors of ammoniagenesis: a role in post-TIPS encephalopathy?



Título del documento: Direct acting inhibitors of ammoniagenesis: a role in post-TIPS encephalopathy?
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000415003
ISSN: 1665-2681
Autores: 1
1
1
Instituciones: 1University of Virginia, Health System, Charlottesville, Virginia. Estados Unidos de América
Año:
Periodo: Mar-Abr
Volumen: 13
Número: 2
Paginación: 179-186
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés A limited number of medications are typically considered for the management of hepatic encephalopathy occurring as a complication of transjugular intrahepatic portosystemic shunt (TIPS) placement. Multiple alternative compounds aimed at disrupting ammoniagenesis are or will soon be available, though their use tends to be limited by a lack of large data sets and of clinical awareness. In this review, we provide a targeted overview of the mechanisms and availability of five anti-ammoniagenic compounds (sodium phenylbutyrate, glycerol phenylbutyrate, sodium benzoate, L-ornithine L-aspartate, and ornithine phenylacetate) identified as possibly useful alternative therapeutic agents for cirrhotic encephalopathy. Three of these medications have been FDA approved for use in congenital urea cycle disorders only, while two are under active investigation for use in cirrhotic patients. In spite of limitations posed by cost and comorbidities, familiarity with these options may prove beneficial in cases refractory to conventional management
Disciplinas: Medicina
Palabras clave: Farmacología,
Gastroenterología,
Encefalopatía hepática,
Metabolismo de la urea,
Amonio,
Fenilbutirato sódico,
Glicerol fenilbutirato,
Benzoato de sodio,
Ornitina
Keyword: Medicine,
Gastroenterology,
Pharmacology,
Liver encephalopathy,
Urea metabolism,
Ammonia,
Sodium phenylbutyrate,
Glycerol phenylbutyrate,
Sodium benzoate,
Ornithine
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