Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Rational Prescribing of Pancreatic Enzymes for Patients with Pancreatic Cancer

Version 1 : Received: 6 February 2024 / Approved: 7 February 2024 / Online: 7 February 2024 (10:13:37 CET)

A peer-reviewed article of this Preprint also exists.

Garcia, M.A.G.; Imam, S.; Braun, U.K.; Jackson, L.K. Rational Prescribing of Pancreatic Enzymes for Patients with Pancreatic Cancer. Pharmacy 2024, 12, 47. Garcia, M.A.G.; Imam, S.; Braun, U.K.; Jackson, L.K. Rational Prescribing of Pancreatic Enzymes for Patients with Pancreatic Cancer. Pharmacy 2024, 12, 47.

Abstract

Most patients with pancreatic cancer at some point present with symptoms related to exocrine pancreatic insufficiency (EPI). These include diarrhea, abdominal bloating, indigestion, steatorrhea, weight loss, and anorexia. Even though up to 80% of pancreatic cancer patients eventually present with symptoms related to exocrine pancreatic insufficiency, only 21% are prescribed pancreatic enzyme replacement therapy. This treatment is profoundly underutilized in the palliative care of these patients. The objective of this review is to discuss the pharmacology, pharmacokinetics, side effects, available evidence of effectiveness of pancreatic enzyme use for patients with pancreatic cancer, and challenges along with proposed solutions regarding its use. Pancrelipase is an expensive drug, and it is inactive if not taken correctly. The impact of symptoms of EPI can lead to poorer overall well-being. Pharmacists play a crucial role in properly educating patients on the correct use of pancreatic enzyme replacement therapy. Pancreatic enzyme replacement therapy (PERT) is a key strategy in managing symptoms of EPI and can improve quality of life, which is a central focus in palliative care.

Keywords

pancreatic cancer; exocrine pancreatic insufficiency; pancreatic enzymes; palliative care; medication instruction; compliance

Subject

Medicine and Pharmacology, Pharmacy

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