MEDIX, God. 21 Br. 117  •  Pregledni članak  •  Gastroenterologija HR ENG

Racionalna farmakoterapija bolesti probavnog sustava antisekretornim lijekovimaRational pharmacotherapy of diseases of the digestive tract using antisecretory drugs

Neven Ljubičić, Neven Baršić, Marko Nikolić

Antisekretorni lijekovi su u prošlosti svojim dolaskom na tržište uvelike unaprijedili liječenje niza bolesti u kojih želučana kiselina ima važnu patofiziološku ulogu – gastroezofagealne refluksne bolesti (GERB), ulkusne bolesti, Zollinger-Ellisonova sindroma, neulkusne dispepsije te infekcije bakterijom H. pylori. To se pogotovo odnosi na inhibitore protonske crpke (IPP), koji su izrazito učinkoviti u liječenju navedenih stanja te su potrebu za, ranije čestim kirurškim zahvatima, sveli na minimum. Prilikom propisivanja antisekretornih lijekova potrebno je voditi računa o mogućim neželjenim učincima i sigurnosti dugotrajne primjene. Iako danas spadaju među najšire propisivane lijekove, s visokom sigurnošću primjene, određena restrikcija u propisivanju IPP-a zasigurno je potrebna, a to se najviše odnosi na poštivanje indikacija i preporučena trajanja terapije. 

Ključne riječi:
antisekretorno liječenje; blokatori H2-receptora; dispepsija; GERB; infekcija bakterijom H. pylori; inhibitori protonske crpke; ulkusna bolest; Zollinger-Ellisonov sindrom

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 21 Br. 117

Antisecretory drugs, after their introduction to the market, significantly improved the treatment of a wide range of disorders where gastric acid has a significant pathophysiological role – gastroesophageal reflux disease (GERD), peptic ulcer disease, Zollinger-Ellison syndrome, non-ulcer dyspepsia, and H. pylori infection. It especially applies to the proton pump inhibitors (PPI), which are extremely effective in treating such conditions and have minimized the need for surgical treatment, which was very frequent prior to their introduction. When prescribing antisecretory drugs it is necessary to take into account the possible adverse effects and safety of long-term use. Although today they are among the most widely prescribed drugs, and have a high safety level, certain restrictions for prescribing PPI are necessary, which applies in particular to the adherence of indications and the recommended duration of treatment. 

Key words:
antisecretory therapy; dyspepsia; gastroesophageal reflux; Helicobacter pylori infection; histamine H2 antagonists; peptic ulcer; proton pump inhibitors; Zollinger-Ellison syndrome