评论文章:刺激性药会伤害肠道吗? 对当前知识进行批判性分析
Peter Whorwell1, Robert Lange2, Carmelo Scarpignato3,4
1Neurogastroenterology Unit, Wythenshawe Hospital, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
Therapeutic advances in gastroenterology
|June 18, 2024
概括
刺激性药,包括塞纳和二甲衍生物,如比萨科迪尔和硫酸盐 (SPS),对于长期的便秘管理是安全的. 证据不支持伤害的说法,他们甚至可能降低结肠癌的风险.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 刺激性药是治疗便秘的常见方法.
- 对于它们的长期安全性存在担忧,特别是对胃肠道系统的影响和致癌性.
研究的目的:
- 综合审查关于长期使用兴奋剂松剂的潜在有害影响的文献.
- 评估二甲 (比萨科迪尔,硫酸盐) 和塞纳药的安全性.
主要方法:
- 在PubMed和Embase的文献搜索到2023年6月.
- 审查43个相关出版物.
主要成果:
- 超治疗剂量导致动物和人类的可逆性,临床上无关的细胞变化.
- 没有人体研究表明长期使用bisacodyl或SPS时神经元件或光滑肌肉的形态变化.
- 没有令人信服的证据将刺激性药与结肠癌联系起来;慢性便秘可能会增加风险.
结论:
- 没有证据表明刺激性药对结肠有有害影响.
- 应重新考虑刺激性药在便秘管理中的长期益处.
相关概念视频
Effects of Chemicals: Overview
Drugs, encompassing various chemical compounds from natural sources, lab synthesis, or genetic engineering, elicit different biological responses in living organisms. Some of these responses are desirable or therapeutic, while others are undesirable. The primary goal of administering a drug is to achieve a therapeutic effect, that is, to address a specific disease or health condition. Any concurrent effects outside of this therapeutic outcome are considered undesirable. These undesirable...
Drug Absorption: Factors Affecting GI Absorption
The process of oral drug absorption can be influenced by several factors. Weakly acidic drugs tend to be absorbed more readily from the stomach due to their nonionized state. However, absorption may be less efficient in the upper intestine, where drugs are often ionized. Interestingly, despite the stomach's apparent advantage for drug absorption, its mucous layer can hinder diffusion. Its surface area is also smaller than the intestine's, which can further slow down the absorption rate.
In...
In...
Combined Effects of Drugs: Antagonism
The combined effects of drugs can result in various interactions, of which an important type is antagonism. Antagonism is a mechanism where one drug inhibits or counteracts the effects of another drug. Antagonism can occur through various means, including receptor binding, allosteric modulation, functional interaction, chemical reactions, and pharmacokinetic processes.
The most common type is receptor antagonism, where one drug acts as an antagonist to block the effects of another drug by...
The most common type is receptor antagonism, where one drug acts as an antagonist to block the effects of another drug by...
Drugs Affecting Neurotransmitter Synthesis
Drugs affecting neurotransmitter synthesis can impact the adrenergic neuron and the synthesis of neurotransmitters. For example, α-methyltyrosine and carbidopa target specific enzymes involved in catecholamine synthesis. α-methyltyrosine inhibits the enzyme tyrosine hydroxylase, which converts tyrosine into dopamine. By blocking this enzyme, α-methyltyrosine reduces dopamine production and other catecholamines. Carbidopa, on the other hand, inhibits the enzyme dopa decarboxylase, which converts...
Drug Absorption: Overview
The process of drug absorption signifies the transition of a drug from its site of administration into the plasma. This process is influenced by various factors, including the route of administration, the anatomy of the absorption site, the mechanism of absorption, gut motility, and the drug's physicochemical properties.
When drugs are injected intravenously, they directly enter the systemic circulation. Alternatively, orally administered drugs navigate through the gastrointestinal (GI) tract.
When drugs are injected intravenously, they directly enter the systemic circulation. Alternatively, orally administered drugs navigate through the gastrointestinal (GI) tract.
Drug Toxicity: Dose-Dependent Reactions
Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...


