Nonsterodial anti-inflamatuvar ilaçların yan etkileri üzerine proton pompa inhibitörleri ve h2reseptör blokörlerinin etkisinin değerlendirilmesi
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2006
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Selçuk Üniversitesi Tıp Fakültesi
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Abstract
Bu çalışmada, çeşitli nedenlerle uzun süreli NSA kullanması gereken hastalarda, bu ilaçların mide mukozasında sebep oldukları değişiklikler üzerine Lansoprazol ve Famotidin tedavilerinin etkileri araştırıldı. 120 olgu A grubu (Lansoprazol), B grubu (Famotidin) ve hızlı üreaz testi ile Hp tesbit edilen C grubu (Eradikasyon tedavisi) olmak üzere üç gruba randomize edildi. A grubunda yaşları 49,7 ± 10,7 (26-70) yıl olan 37 olguya Lansoprazol 30 mg kapsül 12 saat ara ile oral yoldan (PO) verildi. B grubunda yaşları 49,8 ± 12,9 (18-68) yıl olan 32 olguya famotidin 40 mg tablet günde bir kez PO verildi. C grubunda yaşları 46,01 ± 10,18 (21-67) yıl olan 51 olguya 14 gün Klaritromisin 500 mg günde iki kez, 1000 mg Amoksisilin günde iki kez ve 1 ay süreyle Lansoprazol 30 mg günde iki kez PO verildi. Tüm olgular 3 ay süreyle NSA olarak 550 mg Naproksen sodyum 12 saatte bir kullandılar. Gruplarda birinci ve ikinci aydaki endoskopik skorlar, ilaçlara bağlı yan etkiler, hematolojik ve biyokimyasal parametreler üzerine olan etkiler değerlendirildi. Lansoprazol, Famotidin ve eradikasyon tedavisi gruplarında NSA alımının devam etmesine rağmen 1. ve 2. aydaki endoskopik skorlar bazal skorlara göre istatistiksel olarak anlamlı düzeyde düşük bulundu (p<0,05). Bununla birlikte gruplar arasında anlamlı farklılığa rastlanmadı (p>0,05). Çalışmadaki tüm ilaçlar olgular tarafından iyi tolere edildiler. Gruplar arasında yan etki görülme sıklığı açısından karın ağrısı dışında farklılık görülmedi (p<0.05), karın ağrısı eradikasyon tedavisi verilen grupta daha sık görüldü (p<0,05). Lansoprazol, famotidin ve eradikasyon tedavisi gruplarında ilaçların hematolojik ve biyokimyasal de erler üzerine etkisi olmadı (p>0.05). Sonuç olarak; Uzun dönem NSA kullanması gereken olgularda gastrik hasar gelişimini önlemede lansoprazol ve famotidin benzer etkinlikte bulundu.
In this study, we aimed to investigate the effects of Lansoprazole and Famotidine drug therapies on the changes of gastric mucosae in patients who used long term NSA D for several reasons. In our investigation, we arranged the 120 patients in three groups as group A (Lansoprazole), group B (Famotidine) and group C who were found Hp positive with rapid ureas test (Eradication therapy). In group A, 37 patients whose ages were 49,7 ± 10,7 years (26-70 ) were applied oral 30 mg Lansoprazole per 12 hours intervals. In group B, 32 patients ages ranging 49,8 ± 12,9 (18-68) years treated with 40 mg Famotidine therapy two times a day per oral. In group C,51 patients whose ages were 46,01 ± 10,18 (21-67) were undergo 500 mg Clarithromycin therapy twice a day for 14 days, 1000 mg Amoxicillin therapy twice a day for 14 days and 30 mg Lansoprozole therapy twice a day for during one month per oral. During 3 months, all the patients were applied 500 mg Naproxen sodium per 12 hours intervals. At the first and second months the effects of these three drugs were investigated about endoscopy scores, drugs side effects, hematological and chemical parameters in these groups. Although countinuing to the taking of NSAID in the gorups of lansoprazole, famotidine and eradication treatment, the endoscopic scores in the first and second months have been found clearly low towards the basal scores for statistical (p<0,05). At the same time there was no important difference among the groups (p>0,05). All drugs used in the study have been tolerated well by the patients. There was no difference among the groups for having side effects, expect abdominal pain (p>0,05). Abdominal pain was more frequent in the group taking eradication treatment (p<0,05). The drugs had no effect to the hematologic and the biochemistrical parameters in the groups of lansoprazole, famotidine and eradication treatment. As a result, it has been found that lansoprazole and famotidine have similiar effects for preventing gastric erosion in the patients who must use NSAID for a long time.
In this study, we aimed to investigate the effects of Lansoprazole and Famotidine drug therapies on the changes of gastric mucosae in patients who used long term NSA D for several reasons. In our investigation, we arranged the 120 patients in three groups as group A (Lansoprazole), group B (Famotidine) and group C who were found Hp positive with rapid ureas test (Eradication therapy). In group A, 37 patients whose ages were 49,7 ± 10,7 years (26-70 ) were applied oral 30 mg Lansoprazole per 12 hours intervals. In group B, 32 patients ages ranging 49,8 ± 12,9 (18-68) years treated with 40 mg Famotidine therapy two times a day per oral. In group C,51 patients whose ages were 46,01 ± 10,18 (21-67) were undergo 500 mg Clarithromycin therapy twice a day for 14 days, 1000 mg Amoxicillin therapy twice a day for 14 days and 30 mg Lansoprozole therapy twice a day for during one month per oral. During 3 months, all the patients were applied 500 mg Naproxen sodium per 12 hours intervals. At the first and second months the effects of these three drugs were investigated about endoscopy scores, drugs side effects, hematological and chemical parameters in these groups. Although countinuing to the taking of NSAID in the gorups of lansoprazole, famotidine and eradication treatment, the endoscopic scores in the first and second months have been found clearly low towards the basal scores for statistical (p<0,05). At the same time there was no important difference among the groups (p>0,05). All drugs used in the study have been tolerated well by the patients. There was no difference among the groups for having side effects, expect abdominal pain (p>0,05). Abdominal pain was more frequent in the group taking eradication treatment (p<0,05). The drugs had no effect to the hematologic and the biochemistrical parameters in the groups of lansoprazole, famotidine and eradication treatment. As a result, it has been found that lansoprazole and famotidine have similiar effects for preventing gastric erosion in the patients who must use NSAID for a long time.
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Nonsterodial anti-inflamatuvar ilaçlar, Nonsteroidal antiinflammatory drugs, Proton pompa inhibitör, Proton pump inhibitor
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Kaya, C. (2006). Nonsterodial anti-inflamatuvar ilaçların yan etkileri üzerine proton pompa inhibitörleri ve h2reseptör blokörlerinin etkisinin değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
