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Optimizing the Use of Medications and Other Therapies in Infant Gastroesophageal Reflux

机译：优化使用药物和其他疗法在婴儿胃食管反流中的使用

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摘要

Gastroesophageal reflux (GER) is the retrograde movement of gastric (and sometimes duodenal) contents into the esophagus. While the majority of GER is physiologic, for patients, it can be associated with symptoms. While some symptoms are merely bothersome (crying), others can be life threatening (cough, gagging, choking). The main driver of GER in infants is the frequent feedings that produce increased intra-abdominal pressure, which is known to trigger transient relaxations of the lower esophageal sphincter. The recent 2018 clinical practice guidelines reported by the North American and European Societies for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN/ESPGHAN) have recommended non-pharmacologic management initially with subsequent consideration of brief trials with acid suppressants. The main target for these acid suppressants is the gastric parietal cells. Our review of the literature has revealed a paucity of data regarding the use of histamine-2 receptor antagonists and proton pump inhibitors in infants. Despite the absence of well-controlled clinical studies, the prescription rate of these medications has increased internationally. Risks to patients of all ages have become increasingly recognized, with new associations being reported all too often. Here we report our review of all pharmacologic modalities as well as some non-surgical options.
机译：胃食管反流（GER）是胃（有时十二指肠）内容物进入食道的逆行运动。虽然大多数GER是生理的，对于患者，它可能与症状有关。虽然某些症状仅仅是麻烦（哭泣），但其他症状可能是危及危及生命（咳嗽，呕吐，窒息）。婴儿的GER的主要驱动器是常见的喂养，其产生腹内压力增加，这已知是触发较低食管括约肌的瞬时松弛。最近2018年北美和欧洲社会报告的儿科胃肠学，肝脏学和营养（Naspghan / Espghan）报告的临床实践指南推荐了非药剂学管理，最初考虑了与酸性抑制剂的简要试验。这些酸性抑制剂的主要靶标是胃部细胞。我们对文献的审查揭示了关于使用组胺-2受体拮抗剂和婴儿质子泵抑制剂的数据的缺乏。尽管没有受到良好控制的临床研究，但这些药物的处方率正在国际上增加。所有年龄段的患者的风险都越来越认识，新的协会经常报告。在这里，我们举报我们对所有药物模态以及一些非手术选择的审查。

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  • 来源
    《Pediatric drugs》 |2018年第6期|共15页
  • 作者

    Ciciora Steven L.; Woodley Frederick W.;

  • 作者单位

    Nationwide Childrens Hosp Div Gastroenterol Hepatol &

    Nutr Ctr Funct Motil Disorders Columbus;

    Nationwide Childrens Hosp Div Gastroenterol Hepatol &

    Nutr Ctr Funct Motil Disorders Columbus;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 药学;
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