CURRENT TRENDS IN THE PHARMACOTHERAPY FOR GASTROESOPHAGEAL REFLUX DISEASE

被引:24
作者
HIXSON, LJ
KELLEY, CL
JONES, WN
TUOHY, CD
机构
[1] UNIV ARIZONA, COLL PHARM, TUCSON, AZ 85724 USA
[2] VET AFFAIRS MED CTR, MED SERV, TUCSON, AZ USA
[3] VET AFFAIRS MED CTR, PHARM SERV, TUCSON, AZ USA
关键词
D O I
10.1001/archinte.152.4.717
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Medical therapy for gastroesophageal reflux disease should entail a multistep approach. After life-style changes, many patients will require histamine2 receptor antagonists in conventional doses with repeated therapeutic courses, if not continuous maintenance. Prokinetic agents are potentially useful in those patients with impaired motor function of the esophageal or gastric smooth muscle. Combination therapy with histamine2 receptor antagonists and prokinetic agents or sucralfate provides modest healing benefit, if any, over that by histamine2 receptor antagonists alone. For patients with more severe refractory disease, omeprazole has provided unequaled healing rates and accelerated symptomatic relief. High-dose (twofold or more standard dose) histamine2 receptor antagonist therapy may also heal highgrade esophagitis, but the reported experience is small. After healing is achieved, an attempt should generally be made to "step down" therapy to standard-dose histamine2 receptor antagonist as maintenance. Finding the least amount of drug to control symptoms and maintain the integrity of the esophageal mucosa would minimize cost and potential long-term risk.
引用
收藏
页码:717 / 723
页数:7
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