Optimisation of the use of proton pump inhibitors recommends and notes, one article is done!

Proton pump inhibitors (PPI) are gastric acid secretion inhibitors, such as omeprazole, lansolazole, pyroprazole, rebella, aiomeprazole, etc., its fast-acting, acid suppression complete, acid suppression powerful and long-lasting, clinically available Chronic gastritis, gastroesophageal reflux disease (GERD), acidicindigestion,digestionulcers, upper digestive tract bleeding, matching mouth ulcers, reflux esophagitis, Zhuo ai syndrome, stress ulcers and other diseasesCommon dosage forms and commonly used doses of proton pump inhibitorsPPI administration mainly include oral administration (including nasal gastric tube administration) and intravenous administration, its oral dosage forms include intestinal solution tablets, intestinal capsules, oral disintegrating tablets and multi-unit microsacins system, oral disintegrating and multi-unit microscopic systemcans can be used for swallowing difficulties or nasal gastric tubes, while ordinary intestinal solution, slow release or tablets can not be chewed or swallowedPPI oral preparations are omeprazole magnesium intestinal tablets, Lansolaazole intestinal dissolved capsules, Lansolaazole crest, sodium radolazole intestinal tablets, rebellaazole sodium intestinal tablets, aiomeprazole magnesium intestinal tablets, etcPPI()()/()20mg10mg40mg30mg 15mg 30mg 40mg 20mg 40mg 20mg 10mg 20mg 20mg40mg(40mg) 20mg 40mg Note: Oral administration is recommended for 0.5-1h before meals The selection of proton pump inhibitors in common digestive diseases proton pump inhibitors (PPI) by acting on H-K-ATP enzymes, can inhibit the secretion of stomach acid caused by basic and various causes of stimulation, and can inhibit the secretion of stomach acid sourcants mediated by the center or peripheral medial, its acid suppression ability greatly exceeds H2 receptor antagonists (H2RA) and other traditional acid inhibitors, is currently the first choice for clinical treatment and of acid-related diseases common digestive diseases PPI optimization recommendations disease optimization recommendations chronic gastritis with mucosal membrane erosion and / or acid-related symptoms, according to the condition of the choice of PPI, recommended regular dose ppi, 1 time / day, course of 4-6 weeks Gastroesophageal reflux disease (GERD) (1) Initial treatment: recommended for regular dose SUPs, course of 8 weeks; Non-corrosive gastroesophageal reflux disease (NERD) and mild lysergic reflux esophagitis (LA-A and LA-B) can be treated on demand to adjust the treatment plan according to follow-up results (2) Incurable GERD: Incurable GERD patients who are not effective with conventional dose PPI treatment, the dose of PPI can be increased (2 times a day), or replaced with another PPI, and the Short-Term Pre-bedtime joint H2 receptor blocker (H2RA) can be used to improve efficacy Peptic ulcer
usually oral routine dose of PPI, 1 daily, gastric ulcer medication treatment course 6-8 weeks, duodenal ulcer course 4-6 weeks For those with high-risk factors and large ulcers, it is recommended to extend the course of treatment appropriately In combination with antimicrobials, etc (1) eradication Of Hp treatment, PPI is administered twice a day, with 14d If the eradication rate of the 10d course of local radon tetratherapy is close to or reaches 90%, you can choose the 10d course of the four-dtheumy therapy (2) PPI before dinner and take antimicrobial stake after meals Drug-related gastrointestinal mucosa injury and ulcer prevention prevention of nonsteroidal anti-inflammatory drugs (NSAIDs) and antiplatelet drugs caused by gastrointestinal mucosal damage and ulcers, recommended regular dose of PPI administration, daily administration The prevention of stress ulcers high risk of stress ulcers, intravenous lying or dripping regular doses of PPI after the emergence of risk factors, when stable can tolerate adequate intestinal nutrition or have eaten, clinical symptoms began to improve or transferred to a general ward can be changed to oral PPI or gradually discontinued Wednesday Precautions for the use of proton pump inhibitors
PPI general adverse reactions are nausea, gastrointestinal gas, diarrhea, abdominal pain, constipation, dry mouth, headache, dizziness, blurred vision, liver dysfunction, etc., usually mild, self-limiting Occasional whole blood cell reduction, granulocytic deficiency, platelet reduction, anaphylactic shock, bronchial asthma, lupus erythematosus, vascular , interstitial nephritis, joint pain, muscle weakness, skeletal muscle pain and even transverse muscle dissolution Potential adverse reactions to long-term use of PPI (usually more than 6 months) include osteoporosis and fractures, atrophic gastritis, hyperactivity of small intestine bacteria, spontaneous bacterial peritonitis, pneumonia, experimental spores infection , hypomamia, kidney disease, vitamin B12 and iron absorption, tumors, dementia, myocardial infarction acidic sinfies need to play a role in acidic conditions, with PPI drug antagonistic effect, if the combination should be at least 30min interval; Palitancy salt, calcium salt, vitamin B plasma, solubility and absorption reduction, PPI may cause drug-derived acute interstitial nephritis, avoid its use with high-risk drugs of nephrotoxicity, PPI can affect the substrate of the metabolism of CYP450, causing it to eliminate slow down, build up, potentially excessive poisoning, especially the treatment of narrow-window drugs such as geogause, benzene, valin, etc .S .