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Finns det patienter som löper särskild risk för allvarliga biverkningar och komplikationer i övre mag-tarmkanalen?

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Ett antal riskfaktorer är associerade med komplikationer i övre mag-tarmkanalen hos användare av NSAID-preparat (se listan nedan) [7,8].

List: Risk factors for upper GI complications

Om det är möjligt bör patienter med fler än en riskfaktor kanske inte ges ett NSAID-preparat eller också bör de samtidigt få magskyddande behandling.

 

Referenser:

  1. Wallace JL. Nonsteroidal anti-inflammatory drugs and gastroenteropathy: the second hundred years. Gastroenterology 1997;112:1000–16.
  2. Elliott SL, Ferris RJ, Giraud AS, Cook GA, Skeljo MV, Yeomans ND. Indomethacin damage to rat gastric mucosa is markedly dependent on luminal pH. Clin Exp Pharmacol Physiol 1996;23:432–4.
  3. Laine L. The gastrointestinal effects of nonselective NSAIDs and COX-2 selective inhibitors. Semin Arthritis Rheum 2002;32 Suppl 1:25–32.
  4. Hansen JM, Hallas J, Lauritsen J, Bytzer P. Non-steroidal anti-inflammatory drugs and ulcer complications: a risk factor analysis for decision-making. Scan J Gastroenterol 1996;31:126–30.
  5. Singh G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med 1998;105 1B:31S–38S.
  6. Henry D, Lim LL-Y, Garcia Rodriguez LA, Perez Gutthann S, Carson JL, Griffin M et al. BMJ 1996;312:1563–6.
  7. Hawkey CJ, Lanas AI. Doubt and certainty about nonsteroidal anti-inflammatory drugs in the year 2000: a multidisciplinary expert statement. Am J Med 2001;110 Suppl 1A:79S–100S.
  8. Seager JM, Hawkey CJ. ABC of the upper gastrointestinal tract. Indigestion and non-steroidal anti-inflammatory drugs. BMJ 2001;323:1236–1239.
  9. Moore RA, Derry S, Matkinson GT, McQuay HJ. Tolerability and adverse events in clinical trials of celecoxib in osteoarthritis and rheumatoid arthritis: systematic review and meta-analysis of information from company clinical trial reports. Arthritis Res Ther 2005;7:R644–65.
  10. Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. JAMA 2000;284:1247–55.    
  11. Bombadier C, Laine L, Reicin A, Shapiro D, Burgos-Vargas R, Davis B et al. Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis. VIGOR Study Group. N Engl J Med 2000;343:1520–8.
  12. Hawkey CJ, Skelly MM. Gastrointestinal safety of selective COX-2 inhibitors. Current Pharm des 2002;8:1077–89.
  13. Weil J, Colin-Jones D, Langman M, Lawson D, Logan R, Murphy M et al. Prophylactic aspirin and risk of peptic ulcer bleeding. BMJ 1995;310:827–30.
  14. Laine L, Maller ES, Yu C, Quan H, Simon T. Ulcer formation with low dose enteric aspirin and the effect of COX-2 selective inhibition: a double-blind trial. Gastroenterology 2004;127:395–402.
  15. Caldwell B, Aldington S, Weatherall M, Shirtcliffe P, Beasley R. Risk of cardiovascular events and celecoxib: a systematic review and meta-analysis. JR Soc Med 2006;99:132–40.
  16. Chan AT, Manson JE, Albert CM, Chae CU, Rexrode KM, Curhan GC et al. Nonsteroidal anti-inflammatory drugs, acetomiphen and the risk of cardiovascular events. Circulation 2006;Mar 13 (epub ahead of print).
  17. American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Recommendations for the management of rheumatoid arthritis:2002 update. Arthritis Rheum 2002;46:328–46.
  18. Dubois RW, Melmed GY, Henning JM, Laine L. Guidelines for the appropriate use of non-steroidal anti-inflammatory drugs, cyclo-oxygenase-2-specific inhibitors and proton pump inhibitors in patients requiring chronic anti-inflammatory therapy. Aliment Pharmacol Ther 2004;19:197–208.
  19. National Institute for Clinical Excellence. Guidance on the use of cyclo-oxygenase (Cox) II selective inhibitors, celecoxib, rofecoxib, meloxicam and etodolac for osteoarthritis and rheumatoid arthritis. July 2001.
  20. Yeomans ND, Tulassay Z, Juhász L, Rácz I, Howard J, van Rensburg CJ et al. A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal anti-inflammatory drugs. Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-associated Ulcer Treatment (ASTRONAUT) Study Group. N Engl J Med 1998;338:719–26.
  21. Hawkey C, Karrasch JA, Szczepanski L, Walker DG, Barkun A, Swannell AJ et al. Omeprazole compared with misoprostol for ulcers associated with nonsteroidal anti-inflammatory drugs. Omeprazole versus Misoprostol for NSAID-associated Ulcer Management (OMNIUM) Study group. N Engl J Med 1998;338:727–34.

Senast uppdaterad: 2009-04-01

 
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