Nichtsteroidale antientzündliche Pharmaka (NSAID) verfügen über analgetische, antipyretische
und/oder antiphlogistische Eigenschaften. NSAID verursachen jedoch auch Schädigungen
des GI-Traktes. Zur Verhinderung dieser gastrointestinalen Effekte sollten die Patienten
daher routinemäßig einen Mukosaschutz erhalten. Zurzeit ist die Blockade der Protonenpumpen
- (H+/K+-ATPase) - in Parietalzellen durch Protonenpumpeninhibitoren (PPI) die wirksamste
Methode zur Hemmung der Säuresekretion. PPI sind allgemein wirksamer als H2-Blocker und verhinderten sowohl duodenale als auch gastrale Ulzera bei Risiko-Patienten.
Die Häufigkeitsrate der unerwünschten Wirkungen der PPI liegt im Bereich der Anwendung
der H2-Blocker oder eines Placebos. Bei Patienten ohne erhöhtes Risiko für das Auftreten
gastroduodenaler Komplikation ist zur Prävention kardiovaskulärer und/oder zerebrovaskulärer
Ereignisse auch die Anwendung niedrig dosierter ASS in einer magensaftresistenten,
dünndarmlöslichen Darreichungsform in Betracht zu ziehen.
Non-steroidal anti-inflammatory drugs (NSAID) have analgesic, antipyretic and/or antiphlogistic
properties. However, they may also damage the GI tract. Hence, patients should also
be given mucosal protection as a matter of routine. Presently, the most effective
inhibition of acid secretion is blocking of the proton pumps - (H+/K+-ATPase) in parietal cells by means of proton pump inhibitors (PPI). PPIs are generally
more effective than H2 blockers; in high-risk patients, they prevent both duodenal and gastric ulcers. Frequency
rate of undesirable side effects of PPI is within the range of application of H2 blockers or placebos. In case of patients without enhanced risk of gastroduodenal
complications it may also be considered using low-dosage ASA in gastric juice-resistant
and enterosoluble preparations to prevent cardiovascular and/or cerebrovascular incidents.
Key words
NSAID therapy - gastrointestinal effects - mucosal protection - proton pump inhibitors
(PPI) - acetylsalicylic acid (ASA)
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Korrespondenz
Prof. Dr. med. Joachim Neumann
Institut für Pharmakologie und Toxikologie, Martin-Luther-Universität Halle-Wittenberg
Magdeburger Straße 4
06097 Halle (Saale)
Fax: 0345/557-1835
Email: joachim.neumann@medizin.uni-halle.de
