[胃食道逆流性疾病的药物治疗]
1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
概括
管理胃食道逆流性疾病 (GERD) 涉及优化酸抑制疗法,如质子抑制剂 (PPI) 和竞争性酸阻断剂 (P-CABs). 策略包括客观测试,剂量调整和顺序维持治疗,以改善患者的治疗结果和生活质量.
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:
- 胃食道逆流性疾病 (GERD) 是普遍存在的,通常用抑制酸性的药物来治疗.
- 质子抑制剂 (PPI) 是常见的,但可能导致低于最佳的反应或症状复发,影响生活质量和医疗保健成本.
研究的目的:
- 审查目前对GERD的管理策略,重点是优化抑制酸性疗法.
- 讨论PPI不响应的GERD的诊断方法.
- 探索维持治疗的选择,以有效的长期控制症状.
主要方法:
- 关于GERD管理指南和临床研究的文献综述.
- 分析治疗策略,包括药物优化,替代疗法和维护方案.
- 对客观反流监测技术的讨论.
主要成果:
- 优化PPI的坚持,剂量或切换到P-CAB可以改善某些患者的结果.
- 客观的反流监测对于诊断不响应PPI的GERD至关重要.
- 神经调节剂可能有助于功能性胃灼热或反流过敏.
- 连续维护疗法 (每天到按需) 提高了满意度,并减少了药物暴露.
结论:
- 个性化治疗策略对于有效的GERD管理至关重要.
- 客观测试和量身定制的维持疗法,就像连续疗法一样,提高了患者的结果,并尽量减少了药物使用.
相关概念视频
Gastroesophageal Reflux Disease II: Clinical Features and Management
35
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
35
Peptic Ulcer Disease IV: Management
49
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
49
Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
238
Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
238
Barrett Esophagus-II: Clinical Manifestations and Management
75
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
75
Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists
365
Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
365
Esophageal Strictures-II: Clinical Features and Management
19
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
19


