Hayashi Hiroko, Suzuki Akio, Ohata Koichi, Ishihara Masashi, Kubota Yushi, Kobayashi Ryo, Shibata Yuhei, Nakamura Hiroshi, Nakamura Nobuhiko, Kitagawa Junichi, Tsurumi Hisashi, Shimizu Masahito, Itoh Yoshinori
Department of Pharmacy, Gifu University Hospital.
First Department of Internal Medicine, Gifu University Graduate School of Medicine.
Biol Pharm Bull. 2017;40(5):698-702. doi: 10.1248/bpb.b16-01001.
Management of constipation in patients receiving cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) or CHOP-like chemotherapy regimens is important for prevention of paralytic ileus. We reported earlier that the laxative action of magnesium oxide is reversed by the concomitant use of antacids in cancer patients receiving opioid analgesics. Here, we assessed the prevalence of prophylactic laxative medication for the control of constipation in patients receiving CHOP or CHOP-like regimens for non-Hodgkin's lymphoma. Data obtained from 211 eligible patients were retrospectively analyzed. Almost all patients (99%) received anti-ulcer agents such as proton pump inhibitors and H receptor antagonists for the prophylaxis of gastric disorders associated with prednisolone. Prophylactic laxatives were prescribed in 86 patients (40.8%), in which magnesium oxide was used most predominantly (88.4%). However, magnesium oxide at doses of ≦2000 mg/d was not effective for prevention of constipation, although the compound totally inhibited the incidence of constipation at doses higher than 2000 mg/d. Therefore, it is important to avoid negative drug interaction between magnesium oxide and antacids in patients receiving CHOP chemotherapy.
对于接受环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP）或类似CHOP化疗方案的患者，便秘管理对于预防麻痹性肠梗阻很重要。我们之前报道过，在接受阿片类镇痛药的癌症患者中，氧化镁的通便作用会因同时使用抗酸剂而逆转。在此，我们评估了接受CHOP或类似CHOP方案治疗非霍奇金淋巴瘤的患者中预防性使用泻药控制便秘的情况。对从211例符合条件的患者中获得的数据进行了回顾性分析。几乎所有患者（99%）都接受了抗溃疡药物，如质子泵抑制剂和H受体拮抗剂，以预防与泼尼松相关的胃部疾病。86例患者（40.8%）使用了预防性泻药，其中最常用的是氧化镁（88.4%）。然而，剂量≤2000mg/d的氧化镁对预防便秘无效，尽管该化合物在剂量高于2000mg/d时完全抑制了便秘的发生率。因此，对于接受CHOP化疗的患者，避免氧化镁与抗酸剂之间的负面药物相互作用很重要。
