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Itching is one of the most frequent adverse effects of opioid therapy. [4] A common artificial colloid used in clinical fluid management is hydroxyethyl starch (HES). Well-defined side effects, such as coagulopathy, clinical bleeding, anaphylactoid reactions, and pruritus, can make using HES more difficult. [5]
Atorvastatin is primarily eliminated via hepatic biliary excretion, with less than 2% recovered in the urine. Bile elimination follows hepatic and/or extrahepatic metabolism. There does not appear to be any entero-hepatic recirculation. Atorvastatin has an approximate elimination half-life of 14 hours. Noteworthy, the HMG-CoA reductase ...
Muscle pain and other symptoms often cause patients to stop taking a statin. [87] This is known as statin intolerance. A 2021 double-blind multiple crossover randomized controlled trial (RCT) in statin-intolerant patients found that adverse effects, including muscle pain, were similar between atorvastatin and placebo. [88]
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Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
The exact mechanism of the condition is unknown. Some studies have suggested the itching occurs in response to increased fibrinolytic activity in the skin, [5] [6] inappropriate activation of the sympathetic nervous system, [7] increased activity of acetylcholinesterase, [8] [9] or an increase in mast cell degranulation that releases histamine and other chemicals into the body.
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To diagnose a patient with functional itch disorder, the patient should meet three required criteria and three of seven optional criteria. [2] Diagnostic Criteria: [2] 3 Required criteria Localized or generalized pruritus without a primary skin lesion; Chronic pruritus, characterized as being greater than 6 weeks; There is no somatic cause present