Gastrotoxicity of non-steroidal anti-inflammatory drugs and their prescription in Slovakia

Česká verzia

Authors: R. Hudec; M. Kriška; L. Božeková; V. Foltán ¹
Authors place of work: Farmakologický ústav LF UK, Bratislava Prednosta: doc. MUDr. Viera Kristová, CSc. ; Katedra organizácie a riadenia farmácie FaF UK, Bratislava Vedúci: prof. RNDr. Viliam Foltán, CSc. ¹
Published in the journal: Prakt. Lék. 2008; 88(8): 469-471
Category: Of different specialties

Summary

Gastrotoxicity caused by microcirculatory disturbances in gastric mucosa due to blockage of prostaglandine synthesis has different manifestations (from GIT discomfort to perforation of gastric ulcer, or gastric haemorrhage). We analysed the use of non-steroidal anti-inflammatory drugs in ATC class M01 in Slovakia over the period between 1996 and 2007. We found that overall, over the observed period, diclofenac was the most used; though ibuprofen was the most prevalent for the last 4 years of the studied period. Considering long term usage, we have to regard risk factors and quality differences among particular drugs.

Key words:
Non-steroidal anti-inflammatory drugs, consumption, gastrotoxicity.

Zdroje

1. Vane, J.R. Inhibition of prostaglandin synthesis as a mechanism of action for the aspirin-like drugs. Nature 1971, 231, p. 232-235.

2. Baoping, Y., Guoyong, H., Jieping, Y. et al. Cyclooxygenase-2 inhibitor nimesulide suppresses telomerase activity by blocking Akt/PKB activation in gastric cancer cell line. Dig. Dis. Sci. 2004. 49, 6, p. 948-953.

3. Sawynok, J. Topical and peripherally acting analgesics. Pharmacol. Rev. 2003, 55, p. 1-20.

4. Clinard, F., Bardou, M., Sgro, C. et al. Non-steroidal anti-inflammatory and cytoprotective drug co-prescription in general practice. A general practitioner-based survey in France. Eur. J. Clin. Pharmacol. 2001, 57, 10, p. 737-743.

5. Singh, G. Understanding NSAID-PPI-COX-2 interrelationships. Drugs Today (Barc). 2004, 40, (Suppl A), p. 21-24.

6. Henry, D., Lim, L.L., Garcia Rodriguez, L.A. Variability in risk of gastrointestinal complications with individual non-steroidal anti-inflammatory drugs: results of a collaborative meta-analysis. Br. Med. J. 1996, 312, p. 1563-1566.

7. Wallace, J.L. Nonsteroidal anti-inflammatory drugs and gastroenteropathy: The second hundred years. Gastroenterology 1997, 112, p. 1000-1016.

8. Buchanan W.W. Implication of NSAID therapy in elderly patients. J. Rheumatol. 1990, 17, (20 suppl), p. 29-32.

9. Doležal, T., Němeček, K., Kršiak M. Vývoj spotreby analgetík a nesteroidových antireumatík v Českej republike 1990-2000. Čs fyziol. 2001, 50, s. 157-158.

10. Bergman, U., Andersen, M., Vaccheri, A. et al. Deviations from evidence-based prescribing of non-steroidal anti-inflammatory drugs in three European Regions. Eur. J. Clin, Pharmacol. 2000, 56, p. 269-272.

11. Brown, G.J.E., Yeromans, N.D. Prevention of gastrointestinal adverse effects of nonsteroidal antiinflammatory drugs: The role of proton pump inhibitors. Drug Saf. 1999, 21, p. 503-512.

12. Garcia Rodriguez L.A., Jick, H. Risk of upper gastrointestinal bleeding and perforation associated with individual non-steroidal anti-inflammatory drugs. Lancet. 1994, 343, 8900, p. 769-772.

13. Kelly, W.N. Potential risk and prevention, Part I: Fatal adverse reaction. Am. J. Health. Syst. Pharm. 2001, 58, 14, p. 1317-1324.

14. Polimeni, G., Salvo, F., Cutroneo, P. et al. Adverse reactions induced by NSAIDs and antibacterials: analysis of spontaneous reports from the Sicilian regional database. Drug Saf. 2006, 29, 5, p. 449-459.

15. Sbeit, W., Krivoy, N., Shiller, M. et al. Nimesulide induced acute hepatitis. Ann. Pharmacother.. 2001, 35, p. 1049-1051.

16. Schattner, A., Sokolovskaya, N., Cohen, J. Fatal hepatitis and renal failure during treatment with nimesulide. J. Int. Medicine. 2000, 247, p. 153-155.

17. Hawkey, C., Kahan, A., Steinbruck, K. et al. Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br. J. Rheumatol. 1998, 37, 9, p. 937-945.

18. Vonkeman, H.E., Brouwers, J.R., van de Laar, M.A. Understanding the NSAID related risk of vascular events. Br. Med. J. 2006, 332, 7546, p. 895-898.

19. Dieppe, P., Bardett, Ch., Davey, P. et al. Balancing benefits and harms:the example of non-steroidal anti-inflammatory drugs. Br. Med. J. 2004, 329, p. 31-34.