Re: Re: are you sure?

[Guest guest]

Thanks

You made up that list!!!???!!!

I should have known ....you ARE my hero ...and I let you know how your list works for me tomorrow!

Take care!

Don

Ps Think should ask his Doc about phenobarbital vs Rifampin?

To: Sent: Wednesday, February 4, 2009 7:30:32 PMSubject: Re: are you sure?

Hi Don;

I omitted phenobarbital from the list of medications in the brochure because some studies suggest it is not as effective as rifampin in alleviating pruritus:

1: J Pediatr Gastroenterol Nutr. 1999 Oct;29(4):442- 7. Links

Use of rifampin for severe pruritus in children with chronic cholestasis.

Yerushalmi B, Sokol RJ, Narkewicz MR, D, Karrer FM.

Pediatric Liver Center, Department of Pediatrics, University of Colorado School of Medicine and The Children's Hospital, Denver 80218, USA.

BACKGROUND: Rifampin has been proposed to reduce pruritus in children and adults with chronic cholestasis; however, there is a paucity of published data regarding the use of rifampin in children. METHODS: In an open trial, 24 children were evaluated during a 6-year period. Diagnoses included 13 patients with extrahepatic biliary atresia (54%), six with Alagille's syndrome, three with Byler's disease, and one each with primary sclerosing cholangitis and alpha1-antitrypsin deficiency. All patients had severe pruritus that had not responded adequately to at least 2 months of therapy with ursodeoxycholic acid, diphenhydramine, or phenobarbital and local skin care measures. Treatment was initiated with rifampin, 10 mg/kg per day in two divided doses for 18+/-20 months, and the effect on the severity of pruritus was assessed by a clinical scoring system. RESULTS: Ten patients showed a complete response, 12 a partial response, and 2 no

response. Complete response was more common in extrahepatic cholestasis (64% vs. 10%), whereas partial response was more common in intrahepatic cholestasis (80% vs. 29%). Treatment was associated with reduction of gamma-glutamyl transpeptidase. No clinical or biochemical toxicity of rifampin was observed. CONCLUSIONS: We conclude that for more than 90% of children with chronic cholestasis and severe pruritus unresponsive to other treatments, rifampin appears to be a safe and effective therapy. PMID: 10512405.

Rifampin seems to have fewer side effects than phenobarbital (see below):

Rifampin

http://www.nlm. nih.gov/medlinep lus/druginfo/ meds/a682403. html

Phenobarbital

http://www.nlm. nih.gov/medlinep lus/druginfo/ meds/a682007. html

Rifampin has worked great for my son in terms of itch control.

Good luck with your Dr. visit tomorrow!

Best regards.

Dave

(father of (23); PSC 07/03; UC 08/03)

>> Penny and > > Me to......I don't even see it on this list linked below? But I did look it up?? are you sure he said phenobarb?> > "Phenobarbital is used to treat or prevent seizures. It is also used short-term to treat insomnia, or as a sedative before surgery.> Some people using this medicine have engaged in activity such as driving, eating, or making phone calls AND YOUTUBE videos and later having no memory of the activity. If this happens to you, stop taking phenobarbital and talk with your doctor about another treatment for your sleep disorder."> > http://www.psc- literature. org/PSCMedicatio ns.pdf> > Tomorrows my big day with a real PSC doctor...I'm nervous!>

> Don PSC/UC 11-08