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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Assessing the Need for Proton Pump Inhibitors for Patients Using Long-Term Nonsteroidal Anti-inflammatory Drugs without a History of Ulcers
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Assessing the Need for Proton Pump Inhibitors for Patients Using Long-Term Nonsteroidal Anti-inflammatory Drugs without a History of Ulcers

机译：在没有溃疡历史的情况下，评估使用长期非甾体抗炎药的患者的质子泵抑制剂的需要

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摘要

Nonsteroidal anti-inflammatory drugs (NSAIDs) are toxic to the stomach. One proposed mechanism of this toxicity is a prostaglandin-mediated increase in gastric acid secretion.1 If so, it would follow that increasing stomach pH, perhaps by means of an agent such as a proton pump inhibitor (PPI), would help to prevent ulcer complications secondary to NSAID use, such as bleeding and perforation. Clinical practice guidelines have recommended that patients at moderate risk (i.e., having at least one of the following factors: >65 years old; receiving high-dose NSAID therapy; previous history of uncomplicated ulcers; or concurrent use of low-dose acetylsalicylic acid [ASA], corticosteroids, or anticoagulants) be given either cyclooxygenase-2 (COX-2) inhibitors alone or traditional nonselective NSAIDs plus misoprostol or a PPL The UpToDate clinical decision resource recommends PPIs as an option for reducing the risk of gastroduodenal toxicity and suggests that they may prevent ulcers in those who require NSAIDs. We characterized the current evidence and determined the characteristics of patients to whom this evidence would apply.
机译：非甾体抗炎药（NSAIDs）对胃有毒。这种毒性的一种机制是前列腺素介导的胃酸分泌增加。1如果是这样的话，那么可能通过质子泵抑制剂（PPI）等药物增加胃pH值，将有助于预防因使用非甾体抗炎药而继发的溃疡并发症，如出血和穿孔。临床实践指南建议中度风险患者（即，至少有以下因素之一的患者：>65岁；接受高剂量NSAID治疗；既往无并发症溃疡史；或同时使用低剂量乙酰水杨酸[ASA]、皮质类固醇或抗凝剂）单独或传统治疗非选择性NSAIDs加米索前列醇或PPL最新临床决策资源推荐PPI作为降低胃十二指肠毒性风险的选项，并建议它们可以预防需要NSAIDs的患者出现溃疡。我们对目前的证据进行了描述，并确定了这些证据将适用于哪些患者的特征。

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