Creon
enUKCre·on
C0740100 (krē′ŏn′)Creon
(ˈkriːɒn)Cre•on
(ˈkri ɒn)n.
| Noun | 1. | Creon - (Greek mythology) the brother of Jocasta and uncle of Antigone who became king of Thebes after the fall of Oedipus |
n.
Creon
enUKCreon
(krē`ŏn), a name given to several minor legendary Greek kings. In the legend of Oedipus, Creon is the brother of Jocasta and after the death of Oedipus' sons becomes king of Thebes. In Euripides' Medea, Creon is the king of Corinth and is murdered by the vengeful Medea. Apollodorus portrays him as an early king of Thebes who purifies Amphitryon after the murder of his uncle.Creon
Creon
Creon
enUKpancrelipase
Pharmacologic class: Pancreatic enzyme
Therapeutic class: Digestant
Pregnancy risk category C
Action
Catalyzes hydrolysis of fats to mono-glyceride, glycerol, and free fatty acids; proteins into peptides and amino acids; and starches into dextrins and short chain sugars, such as maltose and maltriose, in the duodenum and proximal small intestine, thereby acting like digestive enzymes physiologically secreted by the pancreas
Availability
Creon
Capsules (delayed-release): 3,000 USP units lipase, 9,500 USP units protease, 15,000 USP units amylase; 6,000 USP units lipase, 19,000 USP units protease, 30,000 USP units amylase; 12,000 USP units lipase, 38,000 USP units protease, 60,000 USP units amylase; 24,000 USP units lipase, 76,000 USP units protease, 120,000 USP units amylase
Pancreaze
Capsules (delayed-release): 4,200 USP units lipase, 10,000 USP units protease, 17,500 USP units amylase; 10,500 USP units lipase, 25,000 USP units protease, 43,750 USP units amylase; 16,800 USP units lipase, 40,000 USP units protease, 70,000 USP units amylase; 21,000 USP units lipase, 37,000 USP units protease, 61,000 USP units amylase
Ultresa
Capsules (delayed-release): 13,800 USP units lipase, 27,600 USP units protease, 27,600 USP units amylase; 20,700 USP units lipase, 41,400 USP units protease, 41,400 USP units amylase; 23,000 USP units lipase, 46,000 USP units protease, 46,000 USP units amylase
Viokace
Tablets: 10,440 USP units of lipase, 39,150 USP units of protease, 39,150 USP units of amylase; 20,880 USP units of lipase, 78,300 USP units of protease, 78,300 USP units of amylase
Zenpep
Capsules (delayed-release): 3,000 USP units lipase, 10,000 USP units protease, 16,000 USP units amylase; 5,000 USP units lipase, 17,000 USP units protease, 27,000 USP units amylase; 10,000 USP units lipase, 34,000 USP units protease, 55,000 USP units amylase; 15,000 USP units lipase, 51,000 USP units protease, 82,000 USP units amylase; 20,000 USP units lipase, 68,000 USP units protease, 109,000 USP units amylase; 25,000 USP units lipase, 85,000 USP units protease, 136,000 USP units amylase
Indications and dosages
➣ Exocrine pancreatic insufficiency due to chronic pancreatitis or pancreatectomy
Adults: Individualize dosage based on clinical symptoms, degree of steatorrhea, and fat content of diet (Viokace)
➣ Exocrine pancreatic insufficiency due to cystic fibrosis (CF), chronic pancreatitis, pancreatectomy, and other conditions
Adults and children age 4 and older: Initially, 500 lipase units/kg/meal to a maximum of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day or less), or less than 4,000 lipase units/g fat ingested per day (Creon)
Children older than age 12 months and younger than age 4: Initially, 1,000 lipase units/kg/meal to a maximum of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day or less), or less than 4,000 lipase units/g fat ingested per day (Creon)
Infants up to age 12 months: 3,000 lipase units/120 ml formula or per breastfeeding (Creon)
Don't exceed recommended maximum dosage set forth by the Cystic Fibrosis Foundation Consensus Conferences Guidelines.
➣ Exocrine pancreatic insufficiency due to CF and other conditions
Adults and children age 4 and older: Initially, 500 lipase units/kg/meal to a maximum of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day or less), or less than 4,000 lipase units/g fat ingested per day (Pancreaze, Zenpep)
Adults and children age 4 and older weighing 28 kg (62 lb) or more: Initially, 500 lipase units/kg/meal to a maximum of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day or less), or less than 4,000 lipase units/g fat ingested per day (Ultresa)
Children older than age 12 months and younger than age 4: Initially, 1,000 lipase units/kg/meal to a maximum of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day or less), or less than 4,000 lipase units/g fat ingested per day (Pancreaze, Zenpep)
Children older than age 12 months and younger than age 4 weighing 14 kg (31 lb) or more: Initially, 1,000 lipase units/kg/meal to a maximum of 2,500 lipase units/kg/meal (or 10,000 lipase units/kg/day or less), or less than 4,000 lipase units/g fat ingested per day (Ultresa)
Infants up to age 12 months: 2,000 to 4,000 lipase units/120 ml formula or per breastfeeding (Pancreaze); 3,000 lipase units/120 ml formula or per breastfeeding (Zenpep)
Don't exceed recommended maximum dosage set forth by the Cystic Fibrosis Foundation Consensus Conferences Guidelines.
Contraindications
None
Precautions
Use cautiously in:
• proteins of porcine origin allergy
• renal impairment, gout, hyperuricemia
• fibrosing colonopathy (with high doses)
• lactose intolerance
• pregnant or breastfeeding patients
• children younger than age 12 (with high doses).
Administration
• Be aware that brands aren't interchangeable.
• Administer capsules whole with meals.
• Give to infants before each feeding but don't mix capsule contents directly into formula or breast milk.
• For infants or patients unable to swallow intact capsules, sprinkle contents on acidic soft food, such as applesauce, yogurt, or other acidic soft food with pH of 4.5 or less.
• Don't mix capsule contents with alkaline foods, such as milk, breast milk, formula, or ice cream.
• Be aware that attempting to divide capsule contents into small fractions to deliver small doses of lipase isn't recommended.
• Be aware that high-dose use (exceeding 6,000 lipase units/kg/meal) of pancreatic enzyme replacement therapy has been associated with fibrosing colonopathy and colonic strictures in children younger than age 12.
Adverse reactions
CNS: dizziness, headache
EENT: nasopharyngitis
GI: nausea, vomiting, diarrhea, constipation, abdominal pain, abnormal feces, flatulence, frequent bowel movements, anal pruritus, fibrosing colonopathy
Hepatic: biliary tract stones
Metabolic: hyperglycemia, hypoglycemia, hyperuricemia
Respiratory: cough
Skin: pruritus, urticaria, rash
Other: viral transmission (theoretical risk), severe allergic reactions
Interactions
None
Patient monitoring
• Monitor patient for hyperglycemia, hypoglycemia, and hyperuricemia.
See Closely monitor patient for signs or symptoms of fibrosing colonopathy (such as abdominal pain or distention, vomiting, intermittent diarrhea, and weight loss) that may be associated with high-dose use.
Patient teaching
• Tell patient or caregiver that capsules must be swallowed whole and shouldn't be crushed or chewed.
• Advise patient or caregiver to take drug with food with a full glass of water.
• Tell patient or caregiver not to hold drug in mouth, to avoid mucosal irritation.
• Tell patient or caregiver that for infants or patients who are unable to swallow intact capsules, contents can be sprinkled on soft acidic food, such as applesauce, yogurt, or other soft acidic food.
• Tell patient or caregiver not to mix capsule contents with alkaline foods, such as milk, breast milk, formula, or ice cream.
• Inform patient or caregiver that brands aren't interchangeable.
See Tell patient or caregiver to inform prescriber of pork allergy and to immediately seek medical attention if allergic reaction occurs.
See Tell patient or caregiver to immediately report signs or symptoms of fibrosing colonopathy (such as abdominal pain or distention, vomiting, intermittent diarrhea, or difficulty passing stool).
• Instruct patient or caregiver to report signs or symptoms of high blood sugar (such as extreme thirst), low blood sugar (such as confusion, shakiness, sweating, or hunger), or high uric acid (pain or swelling around joints).
• Advise breastfeeding patient to consider risk and benefit of drug in providing adequate nutritional support for exocrine pancreatic insufficiency.
• Advise female of childbearing age to notify prescriber if she is pregnant, thinking of becoming pregnant, or is breastfeeding during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions.
pancrelipase
(pan-kre-li-pase) pancrelipase,Creon
(trade name),Pancrease-V
(trade name),Pancreaze
(trade name),Pertyze
(trade name),Ultresa
(trade name),Viokace
(trade name),Zenpep
(trade name)Classification
Therapeutic: digestive agentPharmacologic: pancreatic enzymes
Indications
- Chronic pancreatitis,
- Pancreatectomy,
- Cystic fibrosis,
- GI bypass surgery,
- Ductal obstruction secondary to tumor.
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (digestant effects)
| ROUTE | ONSET | PEAK | DURATION |
|---|---|---|---|
| PO | rapid | unknown | unknown |
Contraindications/Precautions
Adverse Reactions/Side Effects
Ear, Eye, Nose, Throat
- nasal stuffiness
Respiratory
- dyspnea
- shortness of breath
- wheezing
Gastrointestinal
- fibrosing colonopathy (high doses only) (life-threatening)
- abdominal pain (high doses only) (most frequent)
- diarrhea (most frequent)
- nausea (most frequent)
- stomach cramps (most frequent)
- oral irritation
Genitourinary
- hematuria
Dermatologic
- hives
- rash
Metabolic
- hyperuricemia
Miscellaneous
- allergic reactions
Interactions
Drug-Drug interaction
Antacids (calcium carbonate or magnesium hydroxide ) may ↓ effectiveness of pancrelipase.May ↓ the absorption of concurrently administered iron supplements.Alkaline foods destroy coating on enteric-coated products.Route/Dosage
Availability (generic available)
Nursing implications
Nursing assessment
- Assess patient’s nutritional status (height, weight, skin-fold thickness, arm muscle circumference, and lab values) prior to and periodically throughout therapy.
- Monitor stools for high fat content (steatorrhea). Stools will be foul-smelling and frothy.
- Assess patient for allergy to pork; sensitivity to pancrelipase may exist.
- Lab Test Considerations: May cause ↑ serum and urine uric acid concentrations.
Potential Nursing Diagnoses
Imbalanced nutrition: less than body requirements (Indications)Implementation
- Pancreaze is not interchangerable with any other pancrelipase product.
- Oral: Administer immediately before or with meals and snacks.
- Swallow tablets whole; do not crush, break, or chew.
- Swallow capsules whole. If unable to swallow, capsules may be opened and sprinkled on foods. Delayed-release capsules filled should not be chewed (sprinkle on soft, acidic foods that can be swallowed without chewing, such as applesauce or Jell-O) and followed immediately by water or juice to ensure complete ingestion. These medications should not be chewed or mixed with alkaline foods prior to ingestion or coating will be destroyed.
- Half of the prescribed Pancreaze dose for an individualized full meal should be given with each snack. The total daily dose should reflect approximately three meals plus two or three snacks per day.
- Do not mix contents of Pancreaze or Creon capsules directly into breast milk or formula. Capsule contents may be sprinkled on small amounts of acidic soft food with a pH of 4.5 or less (applesauce) and given to the infant within 15 minutes. Contents of the capsule may also be administered directly to the mouth. Follow administration with breast milk or formula.
- Do not mix Zenpep capsule contents directly into formula or breast milk prior to administration. Administer with applesauce, bananas, or pears (commercially prepared) and follow with breast milk or formula.
- Do not chew or retain Ultressa capsule in mouth.
Patient/Family Teaching
- Encourage patients to comply with diet recommendations of health care professional (generally high-calorie, high-protein, low-fat). Dose should be adjusted for fat content of diet. Usually 300 mg of pancrelipase is necessary to digest every 17 g of dietary fat. If a dose is missed, it should be omitted and next dose taken with next snack, as directed. Do not increase dose without consulting health care professional. Several days may be required to determine correct dose. Advise patient to read Medication Guide before starting therapy and with each Rx refill; information may be updated.
- Instruct patient not to chew tablets and to swallow them quickly with plenty of liquid to prevent mouth and throat irritation. Sit upright to enhance swallowing. Eating immediately after taking medication helps further ensure that the medication is swallowed and does not remain in contact with mouth and esophagus for a prolonged period. Patient should avoid sniffing powdered contents of capsules, as sensitization of nose and throat may occur (nasal stuffiness or respiratory distress).
- Advise patients and caregivers notify health care professional if symptoms of fibrosing colonopathy (abdominal pain, distention, vomiting, constipation) occur. Occur more frequently with doses exceeding 6000 lipase units/kg of body weight per meal (10,000 lipase units/kg of body weight/day) and have been associated with colonic strictures in children below the age of 12 years.
- Instruct patient to notify health care professional if joint pain, swelling of legs, gastric distress, or rash occurs.
- Advise female patients to notify health care professional if pregnancy is planned or suspected, or if breast feeding.
Evaluation/Desired Outcomes
- Improved nutritional status in patients with pancreatic insufficiency.
- Normalization of stools in patients with steatorrhea.
Creon
A brand name for PANCREATIN.CREON
| Acronym | Definition |
|---|---|
| CREON | |
| CREON |
Creon
enUK- noun
Words related to Creon
noun (Greek mythology) the brother of Jocasta and uncle of Antigone who became king of Thebes after the fall of Oedipus
Related Words
- Greek mythology