For the description below, choose the SINGLE most appropriate drug treatment.
A 27-year-old woman presents at 33 weeks in her first pregnancy. She is complaining of generalized itching, worse on the palms of her hands and soles of her feet.Abdominal examination is unremarkable. Blood investigations reveal that she has increased bile acids.
a.Calcium supplements
b.Erythromycin
c.Nifedipine
d.Magnesium sulphate
e.Ursodeoxycholic acid
Answer
E
Ursodeoxycholic acid is used in the symptomatic treatment of obstetric cholestasis. It chelates bile acids and reduces the itching associated with the disorder. Ursodeoxycholic acid (INN, BAN and AAN), also known as ursodiol (USAN) and the abbreviation UDCA, is one of the secondary bile acids, which are metabolic byproducts of intestinal bacteria.A Cochrane review looking at primary biliary cirrhosis found that although ursodeoxycholic acid showed a reduction in liver biochemistry, jaundice, and ascites, it did not decrease mortality or liver transplantation
Ursodiol is the only FDA approved drug to treat primary biliary cirrhosis.
The drug reduces cholesterol absorption and is used to dissolve (cholesterol) gallstones in patients who want an alternative to surgery. The drug is very expensive, however, and if the patient stops taking it, the gallstones tend to recur if the condition that gave rise to their formation does not change. For these reasons, it has not supplanted surgical treatment by cholecystectomy.
A 27-year-old woman presents at 33 weeks in her first pregnancy. She is complaining of generalized itching, worse on the palms of her hands and soles of her feet.Abdominal examination is unremarkable. Blood investigations reveal that she has increased bile acids.
a.Calcium supplements
b.Erythromycin
c.Nifedipine
d.Magnesium sulphate
e.Ursodeoxycholic acid
Answer
E
Ursodeoxycholic acid is used in the symptomatic treatment of obstetric cholestasis. It chelates bile acids and reduces the itching associated with the disorder. Ursodeoxycholic acid (INN, BAN and AAN), also known as ursodiol (USAN) and the abbreviation UDCA, is one of the secondary bile acids, which are metabolic byproducts of intestinal bacteria.A Cochrane review looking at primary biliary cirrhosis found that although ursodeoxycholic acid showed a reduction in liver biochemistry, jaundice, and ascites, it did not decrease mortality or liver transplantation
Ursodiol is the only FDA approved drug to treat primary biliary cirrhosis.
The drug reduces cholesterol absorption and is used to dissolve (cholesterol) gallstones in patients who want an alternative to surgery. The drug is very expensive, however, and if the patient stops taking it, the gallstones tend to recur if the condition that gave rise to their formation does not change. For these reasons, it has not supplanted surgical treatment by cholecystectomy.
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