비스테로이드소염제를 투약하는 환자에서 소화성궤양의 예방
Prevention of Non-steroidal Anti-inflammatory Drug-induced Peptic Ulcers
추성준, 윤규태, 김준성,
소속 상세정보
추성준 ( Chu Seong-Jun )
Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine
윤규태 ( Yoon Kyu-Tae )
Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine
김준성 ( Kim Joon-Sung )
Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine
Abstract
Nonsteroidal anti-inflammatory drugs (NSAID) are some of the most commonly prescribed medications in clinical practice. The long-term use of NSAIDs is one of the main causes of peptic ulcers and the increased risk of upper gastrointestinal tract complications, such as perforation and bleeding. Thus, the prevention of NSAID-induced peptic ulcers is an important clinical issue. Previous studies have evaluated various strategies for preventing ulcers in patients requiring prolonged NSAID use. The Korean clinical practice guidelines have been published recently based on the evidence of the currently available data. This review describes the strategies for the prevention of peptic ulcers due to NSAID. An assessment of the risk factors for peptic ulcers from NSAID is recommended to identify patients who should be considered for primary prophylaxis. The risk of NSAID-induced peptic ulcers can be reduced by the concomitant use of proton pump inhibitors (PPI), misoprostol, and histamine-2 receptor antagonists. Selective cyclooxygenase-2 inhibitors can be used with caution due to concerns regarding cardiovascular toxicity. Attempts should be made to use the lowest dose and shortest duration of the NSAID.
키워드
Anti-inflammatory agents, non-steroidal; Peptic ulcer; Primary prevention
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