◎Special consideration
＊25%以上的病患会?发pseudocystes（假孕）intestinal & pancreatic fistula（?管）
＊Pancreatic abscess（脓疡）及pancreatic ascites（腹水），这些并发症会使EN进行困难。当病患有这些并发症时需考虑使用PN。AP病患可否使用lipid emmulsions?
＊大部分病患可耐受glucose及lipid based formulas，但血中TG浓度>400mg/dl时需hold。无脂肪输液之PN不建议使用>两周以上，易造成必须脂肪酸之缺乏。
◎Drug Point System
＊ Pancreatin---DONNAZYME
＊ Dosage of Adult
＊ Pancreatic insufficiency:2 tablet(1000mg) orally with each meal and 2 tablets
＊ taken with food eaten between meals
＊ Pancrelipase---
＊ Dosage of Adult
＊ 8000-32000 lipase USP units Orally taken per Meal or snack(点 心)。
◎Treatment
急性胰脏炎--- Supportive treatment
＊ Narcotic analgesics usually are necessary for pain relief.最常使用Meperidine because it has no significant effect on the sphincter of Oddi。病患需禁食，直到不再疼痛和nausea。H2-recepter antagonist may be needed in severely ill patients with significant risk factors for stress ulcer bleeding。
◎Treatment
慢性胰脏炎---严重的剧痛,通常需要用到Narcotics，但是也有成瘾性的问题。
＊ 口服补充pancreatic enzyme 可能有益于控制疼痛。
＊ 病患有intractable(难治愈的) pain 可考虑外科手术处理。
◎参考文献
The Washington Manual Of Medical Therapeutics 29th Edition
＊ MICROMEDEX(R) Healthcare Series Vol.
＊ A.S.P.E.N. BOARD OF DIRECTORS