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article 
App\Entity\Article {#528
  -id: 3
  -title: "Granulat-Pellets bringen Mesalazin dort hin, wo es gebraucht wird"
  -teaser: "<p>Das 5-Aminosalicylat Mesalazin ist einer der Grundpfeiler in der Behandlung der chronisch entz&uuml;ndlichen Darmerkrankung (CED) Colitis ulcerosa.</p>"
  -content: """
    <h2>Einleitung</h2>\r\n
    \r\n
    <p>Das 5-Aminosalicylat Mesalazin ist einer der Grundpfeiler in der Behandlung der chronisch entz&uuml;ndlichen Darmerkrankung (CED) Colitis ulcerosa. Oral oder rektal angewendet, wird es sowohl zur Therapie akuter Sch&uuml;be als auch zur langfristigen Erhaltung der klinischen Remission eingesetzt. Entscheidend ist, dass der Wirkstoff Mesalazin in ausreichend hoher Konzentration gezielt an die entz&uuml;ndeten Bereiche der Darmschleimhaut (Mukosa) transportiert wird.<sup>1,2</sup></p>\r\n
    \r\n
    <p>Damit Mesalazin-Pr&auml;parate ihren Wirkstoff genau dort abgeben k&ouml;nnen, wo der Darm entz&uuml;ndet ist, gibt es sie in verschiedenen Darreichungsformen. F&uuml;r die orale Therapie stehen Tabletten sowie Granulat-Pellets zur Verf&uuml;gung.<sup>1,2</sup></p>\r\n
    \r\n
    <h2>Gleichm&auml;&szlig;ige Freisetzung erst im Dickdarm&nbsp;</h2>\r\n
    \r\n
    <p>Granulat-Pellets k&ouml;nnen f&uuml;r die Akut- und Erhaltungstherapie (Basistherapie) bei leichter bis moderater Colitis ulcerosa unterschiedlicher Ausdehnung (Pancolitis, Linksseiten-Colitis, Proktosigmoiditis) eingesetzt werden. Sie sind in unterschiedlichen Zusammensetzungen (Galenik) verf&uuml;gbar, die es erm&ouml;glichen, den Wirkstoff auch bei der Einnahme &uuml;ber den Mund in ausreichender Konzentration in den Darm zu bringen. (2) So gibt es beispielsweise Granulat-Formulierungen ohne magensaftresistenten &Uuml;berzug, die den Wirkstoff kontinuierlich ab dem Magen freisetzen. Andere Granulate wiederum haben einen magensaftresistenten &Uuml;berzug, um eine gezielte Freisetzung des Wirkstoffs im Dickdarm zu gew&auml;hrleisten.&nbsp;</p>\r\n
    \r\n
    <p>In einem solchen Granulat ist der Wirkstoff Mesalazin in winzige, circa einen Millimeter gro&szlig;e Pellets verpackt, die aus mehreren Schichten aufgebaut sind. Ganz au&szlig;en befindet sich eine quellende Gleitschicht, die das Schlucken erleichtert. Als N&auml;chstes folgt ein magensaftresistenter &Uuml;berzug, der daf&uuml;r sorgt, dass sich die Pellets nicht schon im Magen aufl&ouml;sen.<sup>4</sup></p>\r\n
    \r\n
    <p>Der in den Granulat-Pellets enthaltene Wirkstoff wird erst beim &Uuml;bergang von D&uuml;nndarm zum Dickdarm freigesetzt &ndash; dieser Mechanismus h&auml;ngt vom pH-Wert ab. So werden Wirkstoffverluste im Magen und in den oberen D&uuml;nndarmabschnitten vermieden.<sup>2 </sup></p>\r\n
    \r\n
    <p>Im Inneren der Pellets befindet sich dann das Mesalazin, eingebunden in einen Polymer-Matrix-Kern, der f&uuml;r eine zus&auml;tzlich verz&ouml;gerte Wirkstofffreisetzung sorgt.<sup>4</sup></p>\r\n
    \r\n
    <h2>Vorteile gegen&uuml;ber Mesalazin-Tabletten&nbsp;</h2>\r\n
    \r\n
    <p>Da bei Colitis ulcerosa fast immer die distalen Bereiche des Dickdarms betroffen und in erster Linie f&uuml;r die Symptomatik verantwortlich sind, verf&uuml;gen diese Granulat-Pellets dar&uuml;ber hinaus &uuml;ber eine 2-Komponenten-Galenik mit Matrixkern. Sie verz&ouml;gert die Freisetzung des Wirkstoffs aus den Pellets, w&auml;hrend sie den Dickdarm durchwandern, sodass alle Abschnitte im gleichen Ma&szlig;e mit Wirkstoff versorgt werden.<sup>2</sup></p>\r\n
    \r\n
    <p>Bei distaler Colitis ulcerosa (Proktosigmoiditis) sind diese Granulat-Pellets bestimmten (Eudragit-L- &uuml;berzogenen) Mesalazin-Tabletten, die nur &uuml;ber die pH-abh&auml;ngige Wirkstofffreisetzung verf&uuml;gen, nachgewiesenerma&szlig;en signifikant &uuml;berlegen.<sup>5 </sup></p>\r\n
    \r\n
    <h2>Tipps f&uuml;r die Einnahme von Granulat-Pellets&nbsp;</h2>\r\n
    \r\n
    <p>Neben der Freisetzung des Wirkstoffs genau dort, wo er gebraucht wird, haben die Granulat-Pellets zudem den Vorteil, dass sie unabh&auml;ngig von der Nahrungsaufnahme eingenommen werden k&ouml;nnen. Sie m&uuml;ssen nicht wie Tabletten ein bis zwei Stunden vor einer Mahlzeit geschluckt werden.<sup>4 </sup></p>\r\n
    \r\n
    <p>Zur Einnahme werden die Granulat-Pellets direkt auf die Zunge gegeben und unzerkaut mit reichlich Fl&uuml;ssigkeit heruntergeschluckt. Wichtig: Die Granulat-Pellets d&uuml;rfen nicht zerkaut werden.<sup>3</sup></p>\r\n
    \r\n
    <p>&nbsp;</p>\r\n
    \r\n
    <p><strong>Quellen:</strong>&nbsp;</p>\r\n
    \r\n
    <ol>\r\n
    \t<li><a href="https://register.awmf.org/de/leitlinien/detail/021-009" target="_blank">S3-Leitlinie Colitis ulcerosa</a>&nbsp;</li>\r\n
    \t<li><a href="https://de.drfalkpharma.com/de/praeparate/verschreibungspflichtig/salofalk/" target="_blank">Dr. Falk: Salofalk</a>&nbsp;</li>\r\n
    \t<li><a href="https://www.apotheken-umschau.de/medikamente/beipackzettel/salofalk-granu-stix-500-mg-magensaftrretardgran-2145487.html" target="_blank">https://www.apotheken-umschau.de/medikamente/beipackzettel/salofalk-granu-stix-500-mg-magensaftrretardgran-2145487.html</a>&nbsp;</li>\r\n
    \t<li><a href="https://www.deutsche-apotheker-zeitung.de/daz-az/2002/daz-13-2002/uid-5760" target="_blank">https://www.deutsche-apotheker-zeitung.de/daz-az/2002/daz-13-2002/uid-5760</a>&nbsp;</li>\r\n
    \t<li>Leifeld L et al. Mesalazine granules are superior to Eudragit-L-coated mesalazine tablets for induction of remission in distal ulcerative colitis &ndash; a pooled analysis. Aliment Pharmacol Ther. 2011 Nov;34(9):1115-22.</li>\r\n
    </ol>
    """
  -slug: "granulat-pellets-bringen-mesalazin-dort-hin-wo-es-gebraucht-wird-"
  -categories: Doctrine\ORM\PersistentCollection {#516 …}
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  -publishedAt: DateTime @1708440368 {#525
    date: 2024-02-20 14:46:08.0 UTC (+00:00)
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:72
Show trace 
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:73
Show trace 
[
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Flashes

Flashes

Key Value
error 
[
  "Sie müssen eingeloggt sein um diesen Artikel lesen zu können!"
]

Server Parameters

Server Parameters

Defined in .env

Key Value
APP_ENV 
"dev"
APP_SECRET 
"a1d687c7188a8bbff1cb1e7504f8f22f"
DATABASE_URL 
"mysql://apofalk-academy:0az5otq1qeT1QVQK@127.0.0.1:3306/apofalk-academy"
GOOGLE_CAPTCHA_KEY 
"6LeMd_8qAAAAAIYtrI1v6HmANQgT4wNKYuMnDZ0c"
MAILER_DSN 
"smtp://apofalk@creatediv-ld.de:trU5MSwFK643w9o1@mail.your-server.de:587"
MAILER_NAME 
"apofalk.de"
MAILER_USER 
"info@creatediv.de"
MESSENGER_TRANSPORT_DSN 
"doctrine://default?auto_setup=0"
POINTS_FOR_ELEARNING 
"20"
POINTS_FOR_QUIZ 
"10"
POINTS_NEEDED_FOR_CLUB 
"60"
WKHTMLTOPDF_PATH 
"/usr/local/bin/wkhtmltopdf"

Defined as regular env variables

Key Value
APP_DEBUG 
"1"
CONTEXT_DOCUMENT_ROOT 
"/var/www/vhosts/dev-plesk.creatediv.local/apofalk-academy.dev-plesk.creatediv.local/htdocs/public"
CONTEXT_PREFIX 
""
DOCUMENT_ROOT 
"/var/www/vhosts/dev-plesk.creatediv.local/apofalk-academy.dev-plesk.creatediv.local/htdocs/public"
FCGI_ROLE 
"RESPONDER"
GATEWAY_INTERFACE 
"CGI/1.1"
HOME 
"/var/www/vhosts/dev-plesk.creatediv.local"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
HTTP_CONNECTION 
"close"
HTTP_HOST 
"apofalk-academy.dev-plesk.creatediv.local"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
HTTP_X_ACCEL_INTERNAL 
"/internal-nginx-static-location"
HTTP_X_FORWARDED_FOR 
"216.73.216.96"
HTTP_X_FORWARDED_HOST 
"apofalk-academy.dev-creatediv.de"
HTTP_X_FORWARDED_SERVER 
"apofalk-academy.dev-creatediv.de"
HTTP_X_REAL_IP 
"192.168.20.3"
PATH 
"/usr/local/sbin:/usr/local/bin:/usr/sbin:/usr/bin:/sbin:/bin:/snap/bin"
PHP_SELF 
"/index.php"
QUERY_STRING 
""
REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"aUIeubkjwLOp66bSPVeXzQAAAAI"
REDIRECT_URL 
"/fachartikel/granulat-pellets-bringen-mesalazin-dort-hin-wo-es-gebraucht-wird-"
REMOTE_ADDR 
"192.168.20.3"
REMOTE_PORT 
"51284"
REQUEST_METHOD 
"GET"
REQUEST_SCHEME 
"http"
REQUEST_TIME 
1765940921
REQUEST_TIME_FLOAT 
1765940921.0833
REQUEST_URI 
"/fachartikel/granulat-pellets-bringen-mesalazin-dort-hin-wo-es-gebraucht-wird-"
SCRIPT_FILENAME 
"/var/www/vhosts/dev-plesk.creatediv.local/apofalk-academy.dev-plesk.creatediv.local/htdocs/public/index.php"
SCRIPT_NAME 
"/index.php"
SERVER_ADDR 
"192.168.20.6"
SERVER_ADMIN 
"[no address given]"
SERVER_NAME 
"apofalk-academy.dev-plesk.creatediv.local"
SERVER_PORT 
"80"
SERVER_PROTOCOL 
"HTTP/1.0"
SERVER_SIGNATURE 
"<address>Apache Server at apofalk-academy.dev-plesk.creatediv.local Port 80</address>\n"
SERVER_SOFTWARE 
"Apache"
SYMFONY_DOTENV_VARS 
"APP_ENV,APP_SECRET,DATABASE_URL,MESSENGER_TRANSPORT_DSN,MAILER_DSN,MAILER_NAME,MAILER_USER,WKHTMLTOPDF_PATH,GOOGLE_CAPTCHA_KEY,POINTS_NEEDED_FOR_CLUB,POINTS_FOR_QUIZ,POINTS_FOR_ELEARNING"
UNIQUE_ID 
"aUIeubkjwLOp66bSPVeXzQAAAAI"
USER 
"dev-plesk"
proxy-nokeepalive 
"1"