Zusammenfassung
Zyklooxygenasehemmer (NSAR, Coxibe) gehören zu den meist
verwendeten Arzneimitteln. Interaktionen sind daher häufig
und meist unvermeidlich. Wenige von davon sind allerdings akut lebensgefährlich.
Dazu gehören Blutungen aufgrund gehemmter Plättchenaggregationsfähigkeit,
thromboembolische Ereignisse aufgrund der Hemmung vaskulärer Schutzfunktionen,
Magen-Darm-Perforationen durch erhöhte Blutungsneigung und
Verminderung des Organschutzes, akutes Nierenversagen durch Hemmung des
Organschutzes bei gleichzeitiger Belastung. Ein akutes Leberversagen
ist nur für Paracetamol typisch. In welchem Umfang andere
Wirkstoffe dazu beitragen, ist ungeklärt. All diese Risiken
können durch die kundige Auswahl der Wirkstoffe und Wirkstoffkombinationen
deutlich reduziert werden.
Summary
Non-steroidal, anti-inflammatory drugs are the most widely used
remedies worldwide. Drug interactions are frequent, life threatening
ones are rare: Bleeds on the basis of inhibition of platelet aggregation
and loss of organ protection (GI-tract), thrombotic events due to loss
of vasoprotection and increased propensity for blood coagulation
(stroke), acute kidney failure on the basis of loss of kidney protection
by prostaglandins together with stress to the organ and/or drugs
interfering with the renal blood flow. Acute liver toxicity is typical
for acetaminophen. Whether the risk is increased by other hepatoxic
drugs, as diclofenac, is uncertain at present. All risks can be
reduced considerably by avoiding problematic drug interactions.
Schlüsselwörter
Zyklooxygenasehemmer - Coxibe - nicht-steroidale
Antirheumatika - NSAR
Keywords
cyclooxygenase inhibitors - COX-2 inhibitors - non-steroidal anti-
inflammatory drugs - NSAID
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Prof. Dr. med. Dr. h. c. Kay Brune
Institut für Experimentelle und
Klinische Pharmakologie und Toxikologie der Universität Erlangen-Nürnberg
Fahrstr. 17
91054 Erlangen
Phone: 09131/85-22293
Fax: 0049/9131/85-26898
Email: brune@pharmakologie.med.uni-erlangen.de
