NSAID Kullanan Her Hastada Gastrik Profilaksi Gerekli mi?

Yıl 2020, Cilt: 15 Sayı: 3, 69 - 75, 16.10.2020

Kadir Gişi , Murat İspiroğlu , Bülent Kantarçeken

https://doi.org/10.17517/ksutfd.671049

Öz

Non-steroid anti-inflamatuar ilaçları (NSAID) (Aspirin dahil) kullananlarda risk faktörlerine bağlı olarak; %3- 4.5 klinik gastrointestinal (GİS) sistem olayı, 1/70 semptomatik ülser, 1/5 endoskopik ülser, %1.5 (1-4) (major kanama, perforasyon, obstruksiyon vd.) ciddi komplikasyon, 1/150 kanayan ülser, 1/1200 ölüm gelişeceği tahmin edilmektedir. Non-steroid ani-inflamatuar ilaçlar (NSAID) (Aspirin dahil) gastrik ve düodenal ülserle ilişkili anlamlı derecede morbidite ve mortaliteye neden olurlar. Gastrointestinal olay gelişiminde NSAID’ların kendine ait özelliklerine göre risk 20 kata kadar, seçilen doza görede risk 3-7 kata kadar değişebilmektedir. Helicobacter pylori (H. Pylori) ve NSAID peptik ülser oluşumunda bağımsız iki risk faktörüdür. H.pylori eradikasyonu ülser komplikasyonlarını azaltmaktadır. NSAİD kullanan yüksek riskli hastalarda öncelikle misoprostol ( 600mg/gün ve üstü) veya PPI önerilmelidir.Bu derlemede NSAİ ilaç kullanan ve kullanmak zorunda olan hastalarda GİS proflaksisi gerekliliğinin değerlendirilmesi amaçlandı.

Anahtar Kelimeler

Primer proflaksi, , NSAİİ kullanımı, , Proton pompa inhibitörü

Kaynakça

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