scholarly journals Assessing the Need for Proton Pump Inhibitors for Patients Using Long-Term Nonsteroidal Anti-inflammatory Drugs without a History of Ulcers

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Kevin Kwok ◽  
Aaron Tejani
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
History Of ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

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Gastroprotection during long-term NSAID use – what we know after 120 years of observations?

2021 ◽  
Vol 14 (2) ◽  
pp. 132-137
Author(s):  
Michał Lipiński
Keyword(s):  
Side Effects ◽  
Risk Stratification ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Broad Spectrum ◽  
Nsaid Therapy ◽  
Gastrointestinal Complications ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed classes of medications. The broad spectrum of side effects following long-term NSAID therapy includes mainly, but not only, gastrointestinal complications. Risk stratification of the gastrointestinal complications events is an important element of planning NSAIDs therapy, which allows to determine the indications for the use of proton pump inhibitors. This article presents the criteria for assessment and the method of adequate prevention of gastrointestinal side effects in patients receiving long-term NSAID therapy.

Adherence to proton pump inhibitors or H 2 -receptor antagonists during the use of non-steroidal anti-inflammatory drugs

2003 ◽  
Vol 18 (11-12) ◽  
pp. 1137-1147 ◽  
Author(s):  
M. C. J. M. Sturkenboom ◽  
T. A. Burke ◽  
M. J. D. Tangelder ◽  
J. P. Dieleman ◽  
S. Walton ◽  
...  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Receptor Antagonists ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Adverse Gastrointestinal Effects of Nonsteroidal Anti-Inflammatory Drugs

1994 ◽  
Vol 7 (4) ◽  
pp. 144-153
Author(s):  
Brian L. Erstad ◽  
Robert J. Lipsy
Keyword(s):  
Adverse Reactions ◽  
Nsaid Therapy ◽  
Gi Bleeding ◽  
Routine Prophylaxis ◽  
History Of ◽  
Gi Toxicity ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Length Of Therapy

There are a substantial number of adverse reactions attributable to nonsteroidal anti-inflammatory drug (NSAID) therapy, particularly of the gastrointestinal (GI) tract. The stomach is most commonly affected, although injury may occur from esophagus to colon. The incidence of developing serious GI toxicity seems to be three times as great in users compared with nonusers of NSAIDs. Age greater than 60 years, history of GI problems, previous corticosteroid use, and recency of NSAID use seem to increase the risk of toxicity. Short-term studies have found differences in ulceration or bleeding caused by various NSAIDs. However, there are insufficient long-term clinical trials involving adequate numbers of patients to demonstrate substantial advantages for any particular NSAID based on its toxicity profile. Prostaglandin inhibition seems to be one mechanism responsible for the GI toxicity of NSAIDs, but it is probably not the only mechanism. When serious GI bleeding occurs, the NSAID use must be stopped, although omeprazole and misoprostol have been used successfully to treat gastroduodenal ulcerations in patients while continuing NSAID therapy. Misoprostol and possibly omeprazole have effectively prevented GI ulceration associated with NSAID therapy, but questions remain regarding patient selection, length of therapy, and their utility in preventing serious GI bleeding. At this time, routine prophylaxis for patients receiving long-term NSAID therapy cannot be recommended.

scholarly journals Features of manifestations, treatment and prevention of nsaids – induced gastroduodenopathy in patients of different profile departments

2019 ◽  
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Clinical Manifestations ◽  
Duodenal Ulcers ◽  
Group Iii ◽  
Treatment And Prevention ◽  
Group I ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Gastroduodenal Zone

Introduction. Nonsteroidal anti-inflammatory drugs are the most commonly used medicines in medical practice. As literary sources show, they often cause unwanted side-effects. The purpose of our work was to evaluate the frequency, clinical manifestations and morphological features of lesions of the gastroduodenal zone that arise in patients of rheumatologic, neurological profiles and angiosurgery department during the course of treatment with nonsteroidal anti-inflammatory drugs of different groups, to trace the dependence of the frequency of manifestations of the pathology of the stomach and duodenum from simultaneous receiving two nonsteroidal anti-inflammatory drugs and their combination with glucocorticosteroids and anticoagulants. Material and methods. 73 patients who had used NSAIDs for a long time and had endoscopically confirmed medicated gastroduodenopathy. Patients were divided into 3 groups depending on the profile of the department: Group I included - 24 patients of the department of vascular surgery; Group II - 23 patients of the neurological department; Group III - 26 patients with rheumatological profile. Results. Asymptomatic clinical picture of NSAID-gastropathy was found, which did not coincide with the available endoscopic changes in the gastroduodenal tube: in 63% of cases, erosive changes in the mucous membrane were present, and stomach and duodenal ulcers were revealed in 11%. It was also found that in the group of patients receiving proton pump inhibitors, the incidence of gastroduodenopathy was reliably lower (34.2%) than in patients who did not receive them (53.4%). During this study, it was found that the use of selective non-steroidal anti-inflammatory drugs can significantly reduce the probability of developing the pathology of the gastroduodenal zone, compared with non-selective. Conclusions. The course of treatment with nonsteroidal anti-inflammatory drugs should be as short as possible and should be carried out with minimal but effective doses. Parallel prophylactic administration of proton pump inhibitors is appropriate in patients at high risk of developing erosions and ulcers in the background of treatment with these drugs.

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