推 kstarkkman:看了一串專業的英文之後 沒有人會捨得鞭吧 09/16 14:15
推 jackeyman:請問如果服用NSAID期間併用H2-blocker 或是PPI 是否會減 09/16 16:37
→ jackeyman:少ulcer的發生率 ？ 09/16 16:38
: ※ 發信站: 批踢踢實業坊(ptt.cc)
: ◆ From: 118.170.111.175
: ※ 編輯: ls4860 來自: 118.170.111.175 (09/14 21:35)
: 推 azhan:謝謝 09/14 21:36
: 推 Azzurri:tinten是NSAID嗎？？ 09/14 21:52
: → ls4860:台廠的 好像是中化吧 你不會記錯泰寧吧! 09/14 21:54
: 推 powering:2樓是指acetaminophen有沒有歸在NSAID裡的問題 09/14 21:57
: 推 ayoun22:普拿疼會肚子不舒服的情況比較少見 09/15 01:49
: 推 kstarkkman:acetaminophen 不是NSAID ,醫生應該要加一顆胃藥給你的 09/15 10:14
: 推 philman:不用加胃藥吧，如果指一般制酸劑... 機轉不同 09/16 00:24
^^^^^^^^^^
: 推 powering:PPI的pathway也與NSAID pathway不同，但確可以拿來治療 09/16 00:34
: → powering:NSAID-induced ulcer 09/16 00:34
: 推 RayRamirez:推上...加胃藥不會比較好 09/16 00:35
: 推 philman:PPI太貴也非傳統制酸劑，很少醫師願意開PPI 預防胃出血 09/16 00:37
前文恕刪
關於NSAID到底應不應該再附加開個胃藥來避免GI upset
以下出自Micromedex
a) In a large study involving 1921 patients treated with NONSTEROIDAL
ANTI-INFLAMMATORY DRUGS for rheumatoid arthritis, anti-ulcer therapy
including the use of ANTACIDS did not lower the risk of serious
treatment-related gastrointestinal complications. In addition, asymptomatic
patients taking anti-ulcer medications were at HIGHER RISK for serious GI
complications, likely due to suppressing symptoms of GI toxicity (Singh et
al, 1996).
b) Forty healthy volunteers completed a placebo-controlled comparison of a
low-dose ANTACID (Maalox TC, 1 tablet 4 times daily) regimen's ability to
prevent endoscopically evaluated gastric erosion during a 21-day regimen of
NAPROXEN, 500 milligrams twice daily. Active ANTACID- placebo tablet
treatment periods were separated by a 21-day washout. Endoscopy scores for
both gastric and duodenal lesions were higher during active-ANTACID therapy
than when placebo was used, with the difference in gastric lesion scores
reaching statistical significance. Symptom scores did not differ between the
two treatments at any time. Low dose ANTACID therapy may not be protective
and may actually worsen NSAID-induced gastropathy. (Sievert et al, 1991).
重點是Low dose ANTACID therapy may not be protective and may actually worsen
NSAID-induced gastropathy.
所以antacid之所以不用 應該不只是因為機轉不同的原因
PPI pathway也與NSAID pathway不同
但是還是可以用來治療
當然是沒人拿來預防啦 價格也是個問題
可是確有其治療效果 所以路徑不同是沒問題的
有錯請鞭
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※ 編輯: powering 來自: 203.71.94.30 (09/16 01:06)