M. BERTEANU*, C. BERTEANU**, DANIELA CERNEA***, C. CIRSTOIU****, M. CIRSTOIU**, ALICE VLADOIANU***, OANA COANDA***
* Clinica de Recuperare Medicala, Spitalul Universitar de Urgenta Elias Bucuresti ** Clinica de Anestezie-Terapie Intensiva, Spitalul Universitar de Urgenta Bucuresti *** Clinica de Anestezie-Terapie Intensiva, Spitalul Clinic de Urgenta Craiova **** Clinica de Ortopedie-Traumatologie, Spitalul Universitar de Urgenta Elias Bucuresti
REZUMAT
Antiinflamatoarele nesteroidiene (AINS) sunt medicamente eficiente in tratamentul nenumaratelor dureri cronice aparute in anumite boli. S-a estimat ca peste 60 milioane de persoane folosesc AINS, iar unele AINS (aspirina, naproxen, ibuprofen etc) sunt cele mai folosite medicamente din clasa AINS. Tratamentul cronic cu AINS reduce simptomele multor sindroame dureroase artritice, dar induce reactii adverse cum ar fi complicatiile gastrointestinale manifestate prin discomfort abdominal pana la ulceratii gastrointestinale, hemoragii si perforatii. Intr-adevar pe langa inhibitia nonspecifica asupra celor doua izoenzime ale ciclooxigenazei, aspirina si celelalte AINS conventionale induc tulburari gastrointestinale si sunt considerate ca fiind cauza majora a patologiei iatrogene.
Cele mai comune manifestari ale tulburarilor gastrointestinale produse de AINS sunt eroziunile gastroduodenale si ulceratiile, asa numita gastropatie indusa de AINS si care afecteaza 25-50% din persoanele tratate cronic cu AINS. Gastropatia indusa de AINS limiteaza tratamentul prelungit cu AINS si creeaza o problema financiara in sistemul sanitar. CUVINTE CHEIE: AINS, artrita reumatoida/osteoartrita, gastropatie
Endoscopic incidence of gastropathy în elder rheumatoid patiens treated with NSAID
SUMMARY
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many cronically painful medical conditions. The worldwide NSAID market for both occasional chronic users has been conservatively estimated at over 60 million people, and some NSAIDs (aspirin, naproxen, ibuprofen ertc) are among the most popular over the counter drugs. Chronic NSAID treatment effectively reduces the symptoms of many painful arthritic syndromes, but induces adverse gastrointestinal (GI) complications, ranging from abdominal discomfort to life threatening GI ulceration, bleeding, and perforation. Indeed through their non-specific inhibition of the two cyclo-oxygenase isoenzymes, both aspirin and conventional NSAIDs induce gastroduodenal damage and are now considered as a major cause of iatrogenic pathology.
The most common clinical manifestations of NSAID related GI damage to tissue are a combination of gastroduodenal erosions and ulcerations, often called NSAID induced gastropathy, affecting 25-50% of chronic NSAID users. NSAID induced gastropathy may limit long term NSAID treatment and causes a significant financial burden to the healthcare system.
* Clinica de Recuperare Medicala, Spitalul Universitar de Urgenta Elias Bucuresti ** Clinica de Anestezie-Terapie Intensiva, Spitalul Universitar de Urgenta Bucuresti *** Clinica de Anestezie-Terapie Intensiva, Spitalul Clinic de Urgenta Craiova **** Clinica de Ortopedie-Traumatologie, Spitalul Universitar de Urgenta Elias Bucuresti
REZUMAT
Antiinflamatoarele nesteroidiene (AINS) sunt medicamente eficiente in tratamentul nenumaratelor dureri cronice aparute in anumite boli. S-a estimat ca peste 60 milioane de persoane folosesc AINS, iar unele AINS (aspirina, naproxen, ibuprofen etc) sunt cele mai folosite medicamente din clasa AINS. Tratamentul cronic cu AINS reduce simptomele multor sindroame dureroase artritice, dar induce reactii adverse cum ar fi complicatiile gastrointestinale manifestate prin discomfort abdominal pana la ulceratii gastrointestinale, hemoragii si perforatii. Intr-adevar pe langa inhibitia nonspecifica asupra celor doua izoenzime ale ciclooxigenazei, aspirina si celelalte AINS conventionale induc tulburari gastrointestinale si sunt considerate ca fiind cauza majora a patologiei iatrogene.
Cele mai comune manifestari ale tulburarilor gastrointestinale produse de AINS sunt eroziunile gastroduodenale si ulceratiile, asa numita gastropatie indusa de AINS si care afecteaza 25-50% din persoanele tratate cronic cu AINS. Gastropatia indusa de AINS limiteaza tratamentul prelungit cu AINS si creeaza o problema financiara in sistemul sanitar. CUVINTE CHEIE: AINS, artrita reumatoida/osteoartrita, gastropatie
Endoscopic incidence of gastropathy în elder rheumatoid patiens treated with NSAID
SUMMARY
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective medications for the treatment of many cronically painful medical conditions. The worldwide NSAID market for both occasional chronic users has been conservatively estimated at over 60 million people, and some NSAIDs (aspirin, naproxen, ibuprofen ertc) are among the most popular over the counter drugs. Chronic NSAID treatment effectively reduces the symptoms of many painful arthritic syndromes, but induces adverse gastrointestinal (GI) complications, ranging from abdominal discomfort to life threatening GI ulceration, bleeding, and perforation. Indeed through their non-specific inhibition of the two cyclo-oxygenase isoenzymes, both aspirin and conventional NSAIDs induce gastroduodenal damage and are now considered as a major cause of iatrogenic pathology.
The most common clinical manifestations of NSAID related GI damage to tissue are a combination of gastroduodenal erosions and ulcerations, often called NSAID induced gastropathy, affecting 25-50% of chronic NSAID users. NSAID induced gastropathy may limit long term NSAID treatment and causes a significant financial burden to the healthcare system.
KEYWORDS: NSAID, rheumatoid arthritis/osteoarthritis, gastropathy