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Titolo:
Prevention and treatment of non-steroidal anti-inflammatory drug-induced gastro-duodenal damage: rationale for the use of antisecretory compounds
Autore:
Scarpignato, C; Pelosini, I;
Indirizzi:
Univ Parma, Dept Internal Med, Sch Med & Dent, I-43100 Parma, Italy Univ Parma Parma Italy I-43100 Med, Sch Med & Dent, I-43100 Parma, Italy Univ Nantes, Dept Gastroenterol & Hepatol, Fac Med, Nantes, France Univ Nantes Nantes France troenterol & Hepatol, Fac Med, Nantes, France
Titolo Testata:
ITALIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
, volume: 31, anno: 1999, supplemento:, 1
pagine: S63 - S72
SICI:
1125-8055(199904)31:<S63:PATONA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; PROTON PUMP INHIBITOR; MUCOSAL BLOOD-FLOW; ACID-RELATED DISORDERS; POTENTIAL DIFFERENCE; RHEUMATOID-ARTHRITIS; ACETYLSALICYLIC-ACID; PHARMACOLOGICAL PROPERTIES; BICARBONATE SECRETION; GASTRODUODENAL INJURY;
Keywords:
antacids; antisecretory drugs; mucosal damage; NSAIDs;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
112
Recensione:
Indirizzi per estratti:
Indirizzo: Scarpignato, C Maggioretalyv Hosp, Lab Clin Pharmacol, Dept Internal Med, I-43100 Parma, I Maggiore Univ Hosp Parma Italy I-43100 , I-43100 Parma, I
Citazione:
C. Scarpignato e I. Pelosini, "Prevention and treatment of non-steroidal anti-inflammatory drug-induced gastro-duodenal damage: rationale for the use of antisecretory compounds", ITAL J GAST, 31, 1999, pp. S63-S72

Abstract

Gastro-duodenal mucosa possesses an array of defensive mechanisms and non-steroidal anti-inflammatory drugs have a deleterious effect on most of them. This results in a mucosa less able to cope with even a reduced acid lend. The presence of acid appears to be a conditio sine qua non for non-steroidal anti-inflammatory drug-injury, which is in fact pH-dependent. The acute damage induced by acid non-steroidal anti-inflammatory drugs, bike aspirin,can be markedly reduced or even prevented by raising intragastric pH with antacids or antisecretory compounds. Animal studies have clearly shown thatnot only the degree, but also the duration, of acid inhibition is an important factor for prevention of non-steroidal anti-inflammatory drug-induced mucosal damage. As a consequence, proton pump inhibitors (PPIs) appear to be more effective that H-2-receptor antagonists both in preventing and treating gastro-duodenal lesions. While acid suppression seems to be the only effective mechanism for ulcer healing prevention of non-steroidal anti-inflammatory drug-injury might also rely on the mucosal protective activity of these compounds. Clinical pharmacological studies, performed in healthy volunteers, have shown that - as in laboratory animals - elevation of intragastric pH by means of antacids or antisecretory compounds protects against acute NSAID-induced damage. Unlike H-2-blockers, PPIs protect from nonsteroidalanti-inflammatory drug-injury not only the duodenum, but also the stomach,where the majority of mucosal lesions are usually located Although elevation of intragastric pH affects non-steroidal anti-inflammatory drug pharmacokinetics and pharmacodynamics in laboratory animals, a lack of drug-to-druginteraction between PPIs and some of these compounds has been reported in humans. To summarize, clinical and experimental pharmacology support the use of PPIs for the prevention and treatment of non-steroidal anti-inflammatory drug-induced gastro-duoctenal damage. Acid suppression could however; represent only one of the many mechanisms by which these compounds protect gastro-duodenal mucosa. Further studies are, therefore, needed to better elucidate the respective role of the various pharmacological actions in their mucosal protective activity as well as to assess the clinical relevance of each of them.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 12:02:54