Appropriate choice of proton pump inhibitor therapy in the prevention and management of NSAID-related gastrointestinal damage.

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with gastrointestinal adverse effects, ranging from dyspepsia and peptic ulcer disease to more serious complications such as haemorrhage or perforation. NSAID-induced gastrointestinal toxicity is a significant medical problem worldwide. Misoprostol is effective in reducing NSAID-induced mucosal damage, but patient compliance is limited by poor tolerance. Histamine receptor antagonists are relatively effective against duodenal ulcers but offer no significant protection against gastric ulcers. Proton pump inhibitors (PPIs), such as pantoprazole, omeprazole and lansoprazole, have been shown to be effective in preventing the development of gastric and duodenal ulcers in high-risk patients taking NSAIDs. PPI therapy is also beneficial in healing NSAID-induced ulcers and preventing their recurrence in patients requiring ongoing NSAID therapy. PPIs have an excellent safety profile, and pantoprazole--with its low potential for drug-drug interactions--is particularly suitable for administration to elderly patients who often require concomitant treatment with other medications.

• Authors: G Singh, G Triadafilopoulos
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 59 Issue 10 Pg. 1210-7 (Oct 2005) ISSN: 1368-5031 [Print] India
• PMID: 16178990 (Publication Type: Journal Article, Review)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Inflammatory Agents, Non-Steroidal
• Anti-Ulcer Agents
• Benzimidazoles
• Proton Pump Inhibitors
• Sulfoxides
• Pantoprazole
• Omeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Anti-Ulcer Agents (adverse effects, therapeutic use)
• Benzimidazoles (therapeutic use)
• Humans
• Omeprazole (analogs & derivatives, therapeutic use)
• Pantoprazole
• Peptic Ulcer (chemically induced, drug therapy, prevention & control)
• Proton Pump Inhibitors
• Sulfoxides (therapeutic use)