皮质类固醇在炎症性肠病中的适当使用和并发症:全面审查
Joseph D Feuerstein1, David T Rubin2, Faten N Aberra3
1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
概括
皮质类固醇在炎症性肠病中有效诱导缓解,但存在过度使用的风险. 本综述详细介绍了适当的类固醇使用,副作用和特殊的人群考虑,以获得更好的患者结果.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 药理学和治疗学 药理学和治疗学
背景情况:
- 皮质类固醇经常用于炎症性肠病 (IBD) 管理.
- 虽然它们对于诱导缓解至关重要,但它们的过度使用和滥用会带来重大风险.
研究的目的:
- 为了提供一个更新的叙事审查在IBD皮质类固醇的不断发展的使用.
- 专注于适当的皮质类固醇使用,包括施用途径和持续时间.
- 总结副作用和在特殊人群和术后环境中的使用情况.
主要方法:
- 这是一个叙事评论.
- 关于在炎症性肠病中使用皮质类固醇的文献搜索.
主要成果:
- 皮质类固醇在诱导某些IBD病例的缓解中发挥着关键作用.
- 过度使用和滥用皮质类固醇是值得注意的问题.
- 该审查详细说明了适当的使用,施用途径和持续时间.
- 总结了副作用,老年病的使用,怀孕,少数群体和术后环境.
结论:
- 在IBD中优化皮质类固醇的使用对于平衡疗效和最大限度地降低风险至关重要.
- 了解适当的应用和潜在的不良影响对于有效的患者管理至关重要.
- 进一步的研究可能会在不同患者群体的IBD中改进类固醇导向治疗.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
208
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
208
Inflammatory Bowel Disease IV: Pharmacological Management
204
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
204
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
277
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
277
Inflammatory Bowel Disease II: Crohn's Disease
399
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
399
Drugs for Treatment of Ulcerative Colitis in IBD
243
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
243
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
430
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
430


