Kolestiramin: Perbedaan antara revisi

Kolestiramin umumnya digunakan untuk mengobati diare yang disebabkan oleh malabsorpsi asam empedu.[2]<ref name="pmid24602022">{{cite journal | vauthors = Wilcox C, Turner J, Green J | title = Systematic review: the management of chronic diarrhoea due to bile acid malabsorption | journal = Alimentary Pharmacology & Therapeutics | volume = 39 | issue = 9 | pages = 923–939 | date = May 2014 | pmid = 24602022 | doi = 10.1111/apt.12684 | s2cid = 12016216 | doi-access = free }}</ref> Obat ini pertama kali digunakan untuk mengobati diare pada pasien [[penyakit Crohn]] yang telah menjalani reseksi ileum.[3]<ref name="pmid4894463">{{cite journal | vauthors = Hofmann AF, Poley JR | title = Cholestyramine treatment of diarrhea associated with ileal resection | journal = The New England Journal of Medicine | volume = 281 | issue = 8 | pages = 397–402 | date = August 1969 | pmid = 4894463 | doi = 10.1056/NEJM196908212810801 }}</ref> Bagian terminal [[usus halus]] (ileum) adalah tempat asam empedu diserap kembali. Ketika bagian ini diangkat, asam empedu masuk ke usus besar dan menyebabkan [[diare]] karena stimulasi sekresi klorida/cairan oleh kolonosit yang mengakibatkan diare sekretori. Kolestiramin mencegah peningkatan air ini dengan membuat asam empedu tidak larut dan tidak aktif secara osmotik.

Kolestiramin juga digunakan untuk mengendalikan jenis diare asam empedu lainnya. Bentuk diare asam empedu primer dan idiopatik merupakan penyebab umum diare fungsional kronis, yang sering salah didiagnosis sebagai sindrom iritasi usus besar yang didominasi diare (IBS-D), dan sebagian besar pasien ini merespons kolestiramin.[4]<ref name="pmid19570102">{{cite journal | vauthors = Wedlake L, A'Hern R, Russell D, Thomas K, Walters JR, Andreyev HJ | title = Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome | journal = Alimentary Pharmacology & Therapeutics | volume = 30 | issue = 7 | pages = 707–717 | date = October 2009 | pmid = 19570102 | doi = 10.1111/j.1365-2036.2009.04081.x | s2cid = 11327665 | doi-access = free }}</ref> Obat ini bermanfaat dalam pengobatan diare kronis sindrom pascakolesistektomi.[5][6]<ref name="pmid1449156">{{cite journal | vauthors = Sciarretta G, Furno A, Mazzoni M, Malaguti P | title = Post-cholecystectomy diarrhea: evidence of bile acid malabsorption assessed by SeHCAT test | journal = The American Journal of Gastroenterology | volume = 87 | issue = 12 | pages = 1852–1854 | date = December 1992 | pmid = 1449156 }}</ref><ref name="pmid21977493">{{cite journal | vauthors = Danley T, St Anna L | title = Clinical inquiry. Postcholecystectomy diarrhea: what relieves it? | journal = The Journal of Family Practice | volume = 60 | issue = 10 | pages = 632c–632d | date = October 2011 | pmid = 21977493 }}</ref> Kolestiramin juga bermanfaat dalam mengobati diare pasca-vagotomi.[<ref>{{cite journal | vauthors = George JD, Magowan J | title = Diarrhea after total and selective vagotomy | journal = The American Journal of Digestive Diseases | volume = 16 | issue = 7] | pages = 635–640 | date = July 1971 | pmid = 5563217 | doi = 10.1007/BF02239223 | s2cid = 45276562 }}</ref><ref>{{cite journal | vauthors = Gorbashko AI | title = [8The pathogenesis, diagnosis and treatment of postvagotomy diarrhea] | journal = Vestnik Khirurgii Imeni I. I. Grekova | volume = 148 | issue = 3 | pages = 254–262 | date = March 1992 | pmid = 8594740 }}</ref>

Kolestiramin dapat membantu dalam pengobatan infeksi ''[[Clostridioides difficile]]'', untuk menyerap racun A dan B, dan mengurangi diare serta gejala lain yang disebabkan oleh racun ini. Namun, karena bukan anti-infeksi, kolestiramin digunakan bersama dengan [[vankomisin]].[9]<ref name="pmid15149585">{{cite journal | vauthors = Stroehlein JR | title = Treatment of Clostridium difficile Infection | journal = Current Treatment Options in Gastroenterology | volume = 7 | issue = 3 | pages = 235–239 | date = June 2004 | pmid = 15149585 | doi = 10.1007/s11938-004-0044-y | s2cid = 25356792 }}</ref>

Kolestiramin juga digunakan dalam prosedur "pencucian" pada pasien yang mengonsumsi [[leflunomida]] atau teriflunomida untuk membantu eliminasi obat jika terjadi penghentian obat karena efek samping parah yang disebabkan oleh leflunomida atau teriflunomida.[<ref name="pmid19955995">{{cite journal | vauthors = Wong SP, Chu CM, Kan CH, Tsui HS, Ng WL | title = Successful treatment of leflunomide-induced acute pneumonitis with cholestyramine wash-out therapy | journal = Journal of Clinical Rheumatology | volume = 15 | issue = 8 | pages = 389–392 | date = December 2009 | pmid = 19955995 | doi = 10].1097/RHU.0b013e3181c3f87e }}</ref>

Sebuah laporan kasus menunjukkan bahwa kolestiramin mungkin bermanfaat untuk keracunan [[sianobakteri]] (mikrosistin) pada anjing.[11]<ref name="pmid23888515">{{cite journal | vauthors = Rankin KA, Alroy KA, Kudela RM, Oates SC, Murray MJ, Miller MA | title = Treatment of cyanobacterial (microcystin) toxicosis using oral cholestyramine: case report of a dog from Montana | journal = Toxins | volume = 5 | issue = 6 | pages = 1051–1063 | date = June 2013 | pmid = 23888515 | pmc = 3717769 | doi = 10.3390/toxins5061051 | doi-access = free }}</ref>

Salep yang mengandung kolestiramin yang dicampur dengan Aquaphor telah digunakan dalam pengobatan topikal [[ruam popok]] pada [[bayi]] dan [[balita]].[12]<ref>{{cite journal | vauthors = White CM, Gailey RA, Lippe S | title = Cholestyramine ointment to treat buttocks rash and anal excoriation in an infant | journal = The Annals of Pharmacotherapy | volume = 30 | issue = 9 | pages = 954–956 | date = September 1996 | pmid = 8876854 | doi = 10.1177/106002809603000907 | s2cid = 19929362 }}</ref>

Kolestiramin juga mengikat oksalat di saluran cerna, yang pada akhirnya mengurangi pembentukan batu oksalat urin dan kalsium oksalat.[13]<ref>{{cite news|url=https://www.nytimes.com/health/guides/disease/kidney-stones/medications.html |archive-url=https://web.archive.org/web/20131121234357/https://www.nytimes.com/health/guides/disease/kidney-stones/medications.html |archive-date=2013-11-21 |title=Kidney Stones – Medications |work=The New York Times}}</ref>