THE ROLE OF ACID REGULATION IN THE TREATMENT OF NSAID-INDUCED MUCOSAL DAMAGE

被引:12
作者
YEOMANS, ND [1 ]
SKELJO, MV [1 ]
GIRAUD, AS [1 ]
机构
[1] UNIV MELBOURNE, WESTERN HOSP, DEPT MED, PARKVILLE, VIC 3052, AUSTRALIA
关键词
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; GASTRIC ACID; GASTRIC MUCOSA; H2-RECEPTOR ANTAGONISTS; ACID PUMP INHIBITORS;
D O I
10.1159/000200906
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Gastric acid probably exacerbates mucosal injury caused by non-steroidal anti-inflammatory drugs (NSAIDs) in two ways: first, by increasing absorption of NSAIDs, which are weak acids and predominantly in their undissociated form at low pH - this is probably mainly relevant for salicylates; then, by a 'second wave' of injury that leads to deeper erosions, as gastric acid accesses the partially denuded mucosa. Regulation of gastric acid secretion by acid-inhibitory drugs has been shown to decrease acute NSAID-induced injury to varying extents, depending on the drug used and the method of assessing mucosal damage. Healing of chronic NSAID-induced ulcers is slow if NSAID therapy is continued, but is facilitated by treatment with H-2-receptor antagonists or prostaglandins. One study of the acid pump inhibitor omeprazole has shown a high rate of healing, even though NSAID therapy was continued.
引用
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页码:3 / 10
页数:8
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