Bacterial infections associated with pneumonia and tuberculosis
Chest injuries (blunt or penetrating)
Familial Mediterranean fever, an inherited condition that often causes fever and swelling in the abdomen or the lungs
Fungal or parasitic infections
Heart surgery, especially coronary-artery bypass grafting
Cardiac problems (ischemia, pericarditis)
Inflammatory bowel disease
Lung cancer and lymphoma
Other lung diseases like cystic fibrosis, sarcoidosis, asbestosis, lymphangioleiomyomatosis, and mesothelioma
Pneumothorax
Pulmonary embolisms, which are blood clots that enter the lungsWhen the space between the pleurae starts to fill with fluid, as in pleural effusion, the chest pain can be eased but a shortness of breath can result, since the lungs need room to expand during breathing. Some cases of pleuritic chest pain are idiopathic, which means that the exact cause cannot be determined. Diagnosis
A diagnosis of pleurisy or another pleural condition is based on a medical history, physical examinations, and diagnostic tests. The goals are to rule out other sources of the symptoms and to find the cause of the pleurisy so that the underlying disorder can be treated. Physical examination
A doctor uses a stethoscope to listen to the breathing. This method detects any unusual sounds in the lungs. A person with pleurisy may have inflamed layers of the pleurae that make a rough, scratchy sound as they rub against each other during breathing. This is called pleural friction rub. Diagnostic tests
Depending on the results of the physical examination, diagnostic tests are sometimes performed. Chest x-ray
A chest X-ray takes a picture of the heart and lungs. It may show air or fluid in the pleural space.
), an immunosuppressive drug frequently used to prevent transplant rejection; the two drugs should therefore not be administered concomitantly. Orlistat can also impair absorption of the antiarrhythmic amiodarone. The Medicines and Healthcare products Regulatory Agency (MHRA) has suggested the possibility that orlistat could reduce the absorption of antiretroviral HIV medications. Mechanism of action
Orlistat works by inhibiting gastric and pancreatic lipases, the enzymes that break down triglycerides in the intestine. When lipase activity is blocked, triglycerides from the diet are not hydrolyzed into absorbable free fatty acids, and instead are excreted unchanged. Only trace amounts of orlistat are absorbed systemically; the primary effect is local lipase inhibition within the GI tract after an oral dose. The primary route of elimination is through the feces. Orlistat was also found to inhibit the thioesterase domain of fatty acid synthase (FAS), an enzyme involved in the proliferation of cancer cells but not normal cells. However, potential side effects of orlistat, such as inhibition of other cellular off-targets or poor bioavailability, might hamper its application as an effective antitumor agent. One profiling study undertook a chemical proteomics approach to look for new cellular targets of orlistat, including its off-targets. Orlistat also shows potential activity against the Trypanosoma brucei parasite.Orlistat prevents approximately 30% of dietary fat from being absorbed. Legal status
Orlistat is available both with and without a prescription. Australia and New Zealand
In Australia and New Zealand, orlistat is available as a "Pharmacist Only Medicine.