RISK-BENEFIT ASSESSMENT OF OMEPRAZOLE IN THE TREATMENT OF GASTROINTESTINAL DISORDERS

被引：24

作者：

CREUTZFELDT, W

机构：

[1] Department of Medicine, Georg-August-University, Göttingen

[2] Department of Medicine, University of Göttingen, Göttingen, D-37075

来源：

DRUG SAFETY | 1994年 / 10卷 / 01期

关键词：

D O I：

10.2165/00002018-199410010-00005

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

For the treatment of duodenal and gastric ulcer and reflux oesophagitis, especially erosive oesophagitis, omeprazole has an advantage over histamine H-2-receptor antagonists because it heals significantly more patients significantly faster. Adverse effects have been observed during short term treatment with the same frequency as during treatment with H-2-antagonists. Also, maintenance treatment with omeprazole of reflux oesophagitis is significantly superior to H-2-antagonist therapy. During long term treatment for up to 8 years no further drug-related adverse effects have been observed. Moderate hypergastrinaemia occurs in some patients, especially if an omeprazole dosage of 40 mg/day is needed. A slight increase of the agyrophil (endocrine) cell volume density and an extension of micronodular hyperplasia in the oxyntic mucosa after several years of omeprazole treatment seem to be related to the severity of the corpus gastritis and not to drug-induced hypergastrinaemia, because similar changes have been observed in equal frequency in patients not receiving antisecretory drugs. Theoretical arguments against long term treatment with potent acid-suppressing drugs, such as the possible consequences of gastric bacterial overgrowth or hypergastrinaemia, are not supported by clinical observations and epidemiological data and are, therefore, speculative.

引用

页码：66 / 82

页数：17

共 151 条

[1]

Andersson T., Omeprazole drug interaction studies, Clinical Pharmacokinetics, 21, pp. 195-212, (1991)

[2]

Andersson T., Andren K., Cederberg C., Edvardsson G., Heggelund A., Et al., Effect of omeprazole and Cimetidine on plasma diazepam levels, European Journal of Clinical Pharmacology, 39, pp. 51-54, (1990)

[3]

Andersson T., Bergstrand R., Cederberg C., Eriksson S., Lagerstrom P.O., Et al., Omeprazole treatment does not affect the metabolism of caffeine, Gastroenterology, 101, pp. 943-947, (1991)

[4]

Andersson T., Cederberg C., Heggelund A., Lundborg P., The pharmacokinetics of single and repeated once daily doses of 10, 20 and 40mg omeprazole as enteric coated granules, Drug Investigation, 3, pp. 45-52, (1991)

[5]

Andersson T., Cederberg C., Regardh C.G., Skanberg I., Pharmacogenics of various single intravenous and oral doses of omeprazole, European Journal of Clinical Pharmacology, 39, pp. 195-197, (1990)

[6]

Andersson T., Regardh C.G., Lou Y.C., Zhang Y., Dahl M.L., Et al., Polymorphic hydroxylation of S-mephenytoin and omeprazole metabolism in Caucasian and Chinese subjects, Pharmacogenetics, 2, pp. 25-31, (1992)

[7]

Arens M.J., Dent J., Acid pump blockers: what are their current therapeutic roles?, Baillières’s Clinical Gastroenterology, 7, pp. 95-128, (1993)

[8]

Axelson J., Hakanson R., Rosengren E., Sundler F., Hypergastrinaemia induced by acid blockade evokes enterochromaffin-like (ECL) cell hyperplasia in chicken, hamster and guinea-pig stomach, Cell and Tissue Research, 254, pp. 511-516, (1988)

[9]

Bank S., Greenberg R., Blutein M., Magier D., Schulman N., Et al., ’spaced’ omeprazole dosing in maintenance therapy of H2RA resistant reflux esophagitis — results from 6 to 48 months. Abstract, Gastroenterology, 104, (1993)

[10]

Bardhan K.D., Morris P., Thompson M., Dhande D.S., Hinchliffe R.F.C., Et al., Omeprazole in the treatment of erosive oesophagitis refractory to high dose Cimetidine and ranitidine, Gut, 31, pp. 745-749, (1990)

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