bile acid sequestrants

bile acid sequestrants

1. WEST BENGAL UNIVERSITY OF ANIMAL AND FISHERY SCIENCES FACULTY OF FISHERY SCIENCES A SEMINAR ON: BILE ACID SEQUESTRANTS SUBMITTED TO: Dr. Supratim Choudhury Dept. of FPT SUBMITTED BY: Shirsak Mondal B.F.Sc 1 st Year 2 nd semester

2. INTRODUCTION The bile acid sequestrants are a group of resins used to bind certain components of bile in the gastrointestinal tract . They disrupt the enterohepatic circulation of bile acids by combining with bile constituents In general, they are classified as hypolipidemic agents , They are used in the treatment of chronic diarrhea due to bile acid malabsorption .

3. MECHANISM Bile acid sequestrants are polymeric compounds that serve as ion-exchange resins Bile acid sequestrants exchange anions such as chloride ions for bile acids. By doing so, they bind bile acids and sequester them from the enterohepatic circulation. then more bile acids are produced to replace those that have been lost. Because the body uses cholesterol to make bile acids, this reduces the amount of LDL cholesterol circulating in the blood . Bile acid sequestrants are large polymeric structures, and they are not significantly absorbed from the gut into the bloodstream .

4. Medical uses Hyperlipidemia As bile acids are biosynthesized from cholesterol , disruption of bile acid reabsorption will decrease cholesterol levels, in particular, low-density lipoprotein (commonly known as "bad cholesterol") in blood. Consequently, these drugs have been used for the treatment of hypercholesterolemia and dyslipidemia . In chronic liver diseases such as cirrhosis , bile acids may deposit in the skin, causing pruritus (itching). Hence, bile acid sequestrants may be used for the prevention of pruritus in patients with chronic liver disease . Cholestyramine has been used in the treatment of Clostridium difficile infections, in order to absorb toxins A and B.

5. Side-effects As bile acid sequestrants are systemic side-effects. However, they may cause problems in the gastrointestinal tract (GI tract), such as constipation , diarrhea , bloating and flatulence . Some patients complain of the bad taste. designed to stay in the gut, in general, they do not have

6. Drug interactions In addition to bile acids, bile acid sequestrants may also bind drugs in the GI tract, preventing their absorption into the bloodstream. For this reason, it is generally advised that bile acid sequestrants be spaced several hours apart from other drugs . . They can also bind fat-soluble vitamins, such as vitamin A, vitamin D, vitamin E, and vitamin K. This effect could result in a vitamin deficiency, and so checking blood levels and possible supplementation has been suggested.

7. Examples Three drugs are members of this class; all are synthetic polymeric resins: * Cholestyramine (Questran and other propriety names) * Colestipol (Colestid, Colestipid) * Colesevelam (Cholestagel in Europe, Welchol in the USA)

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