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At least 379 records · Page 21Linked to original sources
PubMed1986

Combined treatment with cholestyramine and nicotinic acid in heterozygous familial hypercholesterolaemia: effects on biliary lipid composition.

In ten patients with heterozygous familial hypercholesterolaemia, combination therapy with cholestyramine and nicotinic acid was instituted for a minimum of 2 months. During therapy, plasma low-density lipoprotein levels were reduced by 32%, and low-density lipoprotein to high-density lipoprotein ratios by 40%. The cholesterol saturation of fasting gall-bladder bile was reduced by 33% during treatment. We conclude that long-term combination therapy with cholestyramine and nicotinic acid is practically feasible in heterozygous familial hypercholesterolaemia, normalizes plasma cholesterol and low-density lipoprotein levels in many patients, and does not result in unwanted side-effects on biliary lipids. It should therefore be considered as the therapy of choice in this condition.

Adult↗
PubMed1990

Increased turnover of very low density lipoprotein triglyceride during treatment with cholestyramine in familial hypercholesterolaemia.

Kinetics of very low density lipoprotein (VLDL) triglyceride were determined in seven patients with heterozygous familial hypercholesterolaemia, using a 3H-glycerol technique. The study was repeated after 5-7 weeks of therapy with the bile acid-binding resin, cholestyramine. The rate of synthesis of VLDL triglyceride was increased by 85% (P less than 0.05) during resin therapy. Simultaneously, the fractional catabolic rate of VLDL was increased by 40% (P less than 0.02), so that only a moderate increase in plasma concentration was observed. Repeated measurements of VLDL size by electron microscopy (before, 1 week, and 5-7 weeks after initiation of therapy) indicated that a transient increase in VLDL size occurred in response to cholestyramine. The results are consistent with a stimulatory effect of bile acid sequestrants on VLDL triglyceride production and indicate that, in most subjects, a compensatory increase in VLDL triglyceride removal occurs.

Adult↗
PubMedDate not supplied

Gastrointestinal dialysis of digoxin using cholestyramine.

The pharmacokinetic parameters of digoxin given intravenously (0.075 mg/kg) alone and following treatment with oral cholestyramine (8 gm in 50 ml water) were studied in rabbits. Pretreatment with cholestyramine produced a significant decrease in the serum concentration of digoxin and significantly enhances its systemic clearance as indicated by a statistically significant decrease in the area under the concentration-time curve (AUC), half time of elimination (t 1/2), and mean residence time (MRT). These findings indicate that the idea of gastrointestinal dialysis, known with activated charcoal, could be extended to ion-exchange resins that could be a potentially useful adjunctive measure in the management of drug overdose especially with commonly used drugs with a low therapeutic index like digoxin.

Administration, Oral↗
PubMed1977

The effect of cholestyramine on serum lipids and platelet aggregation of hypercholesterolemic children (type II A) while on high linoleic acid diet.

25 children with familial hypercholesterolemia (type II A) were treated with cholestyramine or placebo in a cross over study during 2 periods of each 10 weeks. The medication was added to a high linoleic acid diet, which had been started at least 1 year earlier. Serum lipids and platelet aggregation were investigated at the end of the 2 periods. On cholestyramine, serum cholesterol levels decreased significantly, whereas the linoleate and oleate content of cholesterylesters and serum triglycerides did not change systematically. Platelet aggregation time, measured with a filtragometer, did not systematically change either.

Adolescent↗
PubMed1981

Analysis of the in vitro interaction between vancomycin and cholestyramine.

Vancomycin and cholestyramine have been utilized both alone and in combination for the treatment of antibiotic-associated pseudomembranous colitis. Previous work for the treatment of antibiotic-associated pseudomembranous colitis. Previous work has demonstrated significant binding of vancomycin by the anion-exchange resin. The antibacterial activity of vancomycin was markedly reduced when the suspension was centrifuged and the supernatant was tested for antibacterial activity. This study confirmed these findings but demonstrated that there was no immediate loss of antibacterial activity of bound vancomycin. The degree of inactivation appeared to be dependent upon the duration of incubation of vancomycin and cholestyramine in the testing system.

Bacillus subtilis↗
PubMed1975

The effect of cholestyramine on intestinal absorption.

Cholestyramine in a mean dosage of 0-6 g/kg/day has been given to 18 children with familial hypercholesterolaemia for between one and two and a half years. With prolonged treatment folate deficiency occurred, as evidenced by a fall in the mean serum folate concentration from 7-7 ng/ml before treatment to 4-4 ng/ml for patients on treatment for over one year; a corresponding lowering of red cell folate was also seen. Oral folic acid 5 mg daily overcame this depletion, and should be given to all patients on long-term anion exchange resins. Prothrombin time has remained normal in all patients; there has been a significant decrease in the mean serum concentrations of vitamins A and E and of inorganic phosphorus over the first two years of treatment, although values remain within the normal range. The routine administration of fat-soluble vitamins appears unnecessary but it is prudent to measure prothrombin time and serum vitamins A and E at intervals. In children who were having a normal intake of dietary fat five out of seven tested had faecal fat of over 5 g/day while on cholestyramine. No chold has developed diarrhoea, and growth has been normal. The concentrations of serum iron, vitamin B12, plasma calcium, and protein did not change significantly in any patient.

Animals↗
PubMed1984

Bile acid drainage by partial small bowel bypass or cholestyramine. Effects on serum cholesterol in Watanabe heritable hyperlipidemic rabbits.

The effects of bile acid drainage on serum cholesterol levels have been investigated in Watanabe heritable hyperlipidemic rabbits, a unique model for homozygous familial hypercholesterolemia. Cholestyramine medication lowered serum cholesterol concentrations with 38%, while a 33% and a 50% small bowel bypass resulted in a decrease of 56 and 48%, respectively. Cholestyramine treatment after either bypass induced a minor additional fall in serum cholesterol. Ileal bypass and ileal resection were equally effective in reducing serum cholesterol. These results indicate the necessity for further investigation into the potential of bile acid drainage as a therapy in homozygous familial hypercholesterolemia.

Animals↗
PubMed1979

Cholestyramine treatment of chronic diarrhea associated with immune deficiency syndrome.

A 5-year-old boy with known severe combined immunodeficiency disease presented with chronic diarrhea, malabsorption and retarded growth. Candida albicans was found in distal duodenal fluid, and invading the intestinal mucosa. Chronic diarrhea persisted after antimycotic therapy, but responded to treatment with cholestyramine. Repeated courses of cholestyramine resin over a 6-month period were required for complete resolution of the gastrointestinal symptomatology.

Candidiasis↗
PubMed1990

Sensory/mixability preference evaluation of cholestyramine powder formulations.

This double-blind, crossover trial compared the sensory and product preparation characteristics of two cholestyramine powder preparations. The study involved 100 healthy volunteers, aged 22-65 (mean 42 years). Questran, a currently marketed product containing sucrose as a sweetener, was compared with Questran Light, a new formulation substituting aspartame for 90 percent of the sucrose. Comparisons were conducted with the two products mixed in water and orange juice. The subjects expressed a significant overall preference for the new formulation mixed in either water (77 percent) or orange juice (80 percent) (p less than 0.01 in both comparisons). Subjects expressed an overwhelming preference for the old product (99 percent) with respect to ease of preparation, although the ratings of the new product were generally neutral rather than negative. The new product is somewhat more difficult to prepare compared with the old cholestyramine preparation, but offers significantly increased patient acceptance based on sensory evaluations.

Adult↗
PubMed1992

Effects of pravastatin sodium alone and in combination with cholestyramine on hepatic, intestinal and adrenal low density lipoprotein receptors in homozygous Watanabe heritable hyperlipidemic rabbits.

Pravastatin sodium (pravastatin), a tissue-selective inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, was administered alone (50 mg/kg) or in combination with cholestyramine, a bile acid sequestrant resin, at the level of 2% in the diet to homozygous Watanabe heritable hyperlipidemic (WHHL) rabbits for 4 weeks. The low density lipoprotein (LDL)-cholesterol levels were reduced by 29% and 56% with pravastatin alone and the combination treatment, respectively. Hepatic LDL receptor activity was increased by 11.2- and 13.9-fold with pravastatin alone and the combination treatment, respectively. The LDL receptor activity in the untreated homozygous WHHL rabbits was only 2.5% of that in the normal rabbits. mRNA for the LDL receptor in the liver was also increased by 2.1- and 3.4-fold with pravastatin alone and the combination treatment, respectively. On the other hand, mRNA for the LDL receptor in the adrenal gland was not affected by pravastatin and the combination treatment, whereas the mRNA in the intestine was increased in both groups. These results suggest the following: 1) the induction of hepatic LDL receptor activity by the treatment of pravastatin alone or in combination with cholestyramine is the main cause of the reduction of serum cholesterol levels by these treatments even in LDL receptor-deficient animals. 2) The induction of the mRNA for the LDL receptor in the liver and intestine, but not that in the adrenal gland, might be a reflection of the tissue-selective inhibition of cholesterol synthesis by pravastatin.

Adrenal Glands↗
PubMed1992

Cost-effectiveness of simvastatin versus cholestyramine: results for Sweden.

Cost-effectiveness ratios were estimated for each of 2 plasma cholesterol-lowering drug therapies, the HMG-CoA reductase inhibitor simvastatin and the well established cholestyramine, in comparison with a nonpreventive drug treatment alternative. The study was confined to Swedish men (aged 37 to 64 years at start of therapy) with total serum cholesterol levels above 6.2 mmol/L who were free of coronary artery disease (CAD). Costs included expected direct costs of plasma cholesterol-lowering treatment less expected savings resulting from preventing CAD. Effects were defined as changes in life expectancy. A discount rate of 5% and Swedish kronor (SEK) 1988 prices were used. The impact on CAD risks was calculated using multivariate logistic risk estimates from the Framingham Heart Study; Swedish estimates were used to calculate intervention costs and changes in healthcare costs. Over the range of cholesterol levels examined (6.2 to 9.8 mmol/L), simvastatin was consistently more cost-effective than cholestyramine.

Adult↗
PubMed1975

Effects of cholestyramine on 1,2-dimethylhydrazine-induced enteric carcinoma in germfree rats.

Oral administration of 1,2-dimethylhydrazine (DMH) induced intestinal neoplasms in germfree rats. A supplement of 2% cholestyramine resin in the diet increased the frequency of DMH-induced intestinal tumors and accelerated malignant transformation. Bile acids in the cecal content were determined with and without cholestyramine in order to obtain a correlation between the bile acid metabolism and the enteric carcinogenesis.

Adenocarcinoma↗
PubMed1976

Protective effects of cholestyramine in rats fed a low-fiber diet containing toxic doses of sodium cyclamate or amaranth.

Immature male rats were fed a purified, low-fiber diet containing massive doses of sodium cyclamate or amaranth (FD and C Red No. 2). Sodium cyclamate when incorporated at a 5% level in the purified, low-fiber diet resulted in toxic manifestations which were counteracted by the concurrent administration of the anion exchange resin cholestyramine at a 2 1/2% level in the diet. Other anion exchange resins were also active in this regard. Cholestyramine at a 2 1/2% level of supplementation was also active in counteracting the toxic effects induced by amaranth when the latter was incorporated at a 5% level in the purified, low-fiber diet.

Amaranth Dye↗
PubMed1976

Cholestyramine: an effective, twice-daily dosage regimen.

Nine patients with familial hypercholesterolemia (type II hyperlipoproteinemia) and two normal volunteers were studied to ascertain the effectiveness of cholestyramine in lowering plasma cholesterol when a twice-a-day dosage regimen was compared with the same total dosage administered four times a day. The study showed that in these subjects the two regimens were equally effective. The ability to administer cholestyramine twice daily in working adults and school children should greatly enhance adherence to this agent.

Adult↗
PubMed2000

Congestive heart failure and toxic digoxin levels: role of cholestyramine.

We report 2 patients with congestive heart failure and concomitant toxic serum digoxin levels in whom cholestyramine administration increased clearance of digoxin and decreased serum digoxin elimination half-lives. Cholestyramine's gastrointestinal binding of enterohepatically-recycled and enterally-secreted digoxin enhanced elimination, allowing a more rapid return to therapeutic drug levels.

Aged↗
PubMed2000

Diarrhea-associated over-anticoagulation in a patient taking warfarin: therapeutic role of cholestyramine.

We present a case of significant over-anticoagulation temporally associated with a bout of protracted diarrhea in a patient on warfarin therapy. Cholestyramine was utilized to interrupt the enterohepatic recycling of warfarin and for its antidiarrheal effects to prevent gastrointestinal vitamin K wasting. Cholestyramine enabled the use of very low doses of sc vitamin K1 (2 mg total) with subsequent attainment of a therapeutic International Normalized Ratio in 39 h.

Aged↗
PubMed1992

Multiple relapses of Clostridium difficile-associated diarrhea in a cancer patient. Successful control with long-term cholestyramine therapy.

Clostridium difficile-associated diarrhea (CDAD) is caused by a toxin elaborated by the anaerobic organism Clostridium difficile. Although the vast majority of CDAD cases are now associated with antibiotic use, the administration of antineoplastic agents alone can result in clinical manifestations. While therapy with oral vancomycin is usually successful, one quarter of patients will relapse. We describe a 16-year-old girl with osteogenic sarcoma whose therapy was significantly complicated by multiple relapses of CDAD. All resulted in hospital admission. She failed several standard therapies for relapsed CDAD and was cured only after prolonged cholestyramine therapy. A subset of multiply relapsed CDAD patients may require prolonged therapy with cholestyramine to control the disease.

Adolescent↗