Summary:
Non-steroid antirheumatics are among very frequently prescribed drugs. They can be, however,
associated with the development of serious and undesirable effects on the digestive tract. Therefore
at present therapeutic procedures are sought which will restrict the negative effect of drugs
on the mucous membranes of the stomach, duodenum and gut in general, incl. new forms of
non-steroid antirheumatics with a „sparing“ effect on the gastroduodenal mucous membranes.
This group of drugs includes preparations with a so-called preferential or specific effect on cyclooxygenase
2 (COX-2). This enzyme is of fundamental importance for the development of mucosal
lesions and its inhibition is the basis of safe medication with non-steroid antirheumatics. Other
possible alternative therapy is the combined administration of non-steroid antirheumatics with
drugs which inhibit the secretion of gastric hydrochloric acid. These drugs include above all
proton pump blocking agents.
The principle of medication with non-steroid antirheumatics should, of course, be careful and
correct indication, knowing possible complications of treatment, and in particular knowledge
which groups of subjects may be threatened by treatment with non-steroid antirheumatics. Preference
of drugs on the basis of COX-2 inhibition is a necessity in these subjects.
Key words:
Non-steroid gastropathies - Non-steroid antirheumatics - COX-1 - COX-2 - Proton pump
blocking agents
|