The Effects of Phenobarbital on Bile Salts and Bilirubin in Patients with Intrahepatic and Extrahepatic Cholestasis

Stiehl, A.; Thaler, Michael; Admirand, William H.

doi:10.1056/nejm197204202861602

Cited by 110 publications

(27 citation statements)

References 19 publications

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“…The results are of interest. Phénobarbital is known to exert beneficial effects on cholestasis of different origin [10]. Therefore, a thera peutic trial with the drug in human cholestasis of viral origin will be justified if the uneffectiveness of PB administration on the course of liver viral infection observed in the present studies in mouse will be confirmed by further investigations in man.…”

Section: Discussionmentioning

confidence: 78%

Effect of Phenobarbital on MHV-3 Viral Hepatitis of the Mouse

Budillon¹,

Carrella²,

DeMarco³

et al. 1973

Pathobiology

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Section: Discussionmentioning

confidence: 78%

Effect of Phenobarbital on MHV-3 Viral Hepatitis of the Mouse

Budillon¹,

Carrella²,

DeMarco³

et al. 1973

Pathobiology

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“…Phénobarbital has been shown to lower serum bili rubin concentration, and to improve pruritus in some forms of intrahepatic cholestasis in infants or children with partial biliary 'atresia' (99,108,113). This effect has also been reported in other forms of intrahepatic cholestasis, i.e.…”

Section: Therapeutic Implicationsmentioning

confidence: 78%

“…benign recurrent cholestasis (108), familial intrahepatic cholestasis (4), or primary biliary cirrhosis (2,112). The mechanism of action of phénobarbital is poorly understood; a decrease in serum bile salt concentration (108), as well as of cholesterol and triglycerides levels, has been noted together with a decrease in skin xanthomas (63). Phénobarbital decreases the plasma half-life and pool size of cholate (109), probably by enhancing fecal excretion (2,109).…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Barbiturates and Biliary Function

Capron

Erlinger²

1975

Digestion

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This paper reviews the principal effects of phenobarbital on biliary function. Phenobarbital administration is followed by an increase in bile flow. This is mainly due to an increase in the bile salt-independent fraction of canalicular bile flow possibly through an increase in canalicular Na⁺-K⁺ ATPase activity. In addition, bile salt excretion may be increased. This effect of barbiturates on choleresis appears to be independent of microsomal enzyme induction. Barbiturates increase the uptake, storage and excretion of various dyes, for example sulfobromophthalein. Phenobarbital increases bilirubin clearance by the liver; it enhances bilirubin-UDP-glucuronyl transferase activity; whether the influence on bilirubin clearance is related to the effect on the enzyme is unknown. The influence of phenobarbital on biliary lipids is markedly different from one species to the other. In the rhesus monkey and in the rat, the relative concentration of cholesterol is decreased; in the hamster it is increased, and in man it appears largely unaffected. These effects of phenobarbital have been utilized in the treatment of chronic unconjugated hyperbilirubinemia and of certain cholestatic syndromes. Phenobarbital alone has not been useful, so far, in the treatment of cholesterol gallstones.

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“…Thus, some may occur because of a paucity of intrahepatic bile ducts [13] and others because of the synthesis of excessive amounts of monohydroxy bile acids [10], which are known to cause cholestasis [8]. Some infants apparently respond rapidly to intramuscular phenobarbital [14] and others have virtually no bile acid in their bile at the time of surgery [11].…”

Section: Discussionmentioning

confidence: 99%