- Interprofessional Care
- Objectives include
- Relief of pain
- Prevention or alleviation of shock
- Decreased pancreatic secretions
- Correction of fluid/electrolyte imbalance
- Prevention/treatment of infections
- Removal of precipitating cause
- Conservative Therapy
- Supportive care
- Aggressive hydration
- Pain management
- IV morphine, antispasmodic agent
- Management of metabolic complications
- Oxygen, glucose levels
- Minimizing pancreatic stimulation
- NPO status, NG suction, decreased acid secretion, enteral nutrition if needed
- Conservative Therapy
- Shock
- Plasma or plasma volume expanders (dextran or albumin)
- Fluid/electrolyte imbalance
- Lactated Ringer’s solution
- Ongoing hypotension
- Vasoactive drugs: dopamine
- Prevent infection
- Enteral nutrition
- Antibiotics
- Endoscopically or CT-guided percutaneous aspiration
- Shock
- Surgical Therapy
- For gallstones
- ERCP
- Cholecystectomy
- Uncertain diagnosis
- Not responding to conservative therapy
- Drainage of necrotic fluid collections
- For gallstones
- Drug Therapy
- IV morphine
- Antispasmodics
- Carbonic anhydrase inhibitors
- Antacids
- Proton pump inhibitors
- Supportive care
- Objectives include
|
Drug |
Mechanism of Action |
|
Acute Pancreatitis |
|
|
Morphine |
Relief of pain |
|
Antispasmodics (e.g., dicyclomine [Bentyl]) |
|
|
Carbonic anhydrase inhibitor (acetazolamide) |
|
|
Antacids |
|
|
Proton pump inhibitors (e.g., omeprazole [Prilosec]) |
|
|
Chronic Pancreatitis |
|
|
Pancreatic enzyme products (pancrelipase [Pancrease, Zenpep, Creon, Viokace]) |
|
|
Insulin |
|
-
-
- Nutritional Therapy
- NPO status initially
- Enteral versus parenteral nutrition
- Monitor triglycerides if IV lipids given
- Small, frequent feedings when able
- High-carbohydrate
- No alcohol
- Supplemental fat-soluble vitamins
- Nutritional Therapy
-
