Domagała-Rodacka Renata, Cibor Dorota, Szczeklik Katarzyna, Rodacki Tomasz, Mach Tomasz, Owczarek Danuta
Przegl Lek. 2016;73(9):652-8.
World Health Organization (WHO) defines adverse drug reaction (ADR) as “a response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modifications of physiological function”. ADRs are a serious problem of contemporary pharmacotherapy. Expenditures for treatment of ADRs in the United States may cost up to 30.1 billion dollars annually. Factors affecting the development of ADRs are: age, gender, body weight, polypharmacy. About 10% of ADRs is associated with gastrointestinal tract (GIT). ADR can affect every part of GIT. Xerostomia is the most common ADR occurring in oral cavity. ADRs affecting esophagus include irritation and inflammation of the mucosa. Approximately one-third of all cases of esophageal inflammation results from administration of non-steroid anti-inflammatory drugs (NSAIDs). The main cause of ulcerations involving stomach and small intestine are NSAIDs. Drug-induced diarrheas are the most common adverse effect accounting for approximately 7% of all observed cases of ADRs. They may be triggered by antibiotics, magnesium salts, laxatives and others. On the other hand, some groups of medications may induce constipation. These drugs comprise opioids, diuretics, calcium channel blockers, cholinolytics and others. Proton pump inhibitors, metformin, orlistat and colesevelam may lead to restricted absorption of certain vitamins and minerals. Physicians’ knowledge about most popular and well documented ADRs can improve patients’ safety and make pharmacotherapy more comfortable for them.
世界卫生组织(WHO)将药物不良反应(ADR)定义为“一种对药物的有害且非预期的反应,该反应发生在人体正常用于疾病预防、诊断或治疗,或生理功能改变的剂量下”。药物不良反应是当代药物治疗中的一个严重问题。在美国,每年用于治疗药物不良反应的费用可能高达301亿美元。影响药物不良反应发生的因素包括:年龄、性别、体重、多种药物联用。约10%的药物不良反应与胃肠道(GIT)有关。药物不良反应可影响胃肠道的各个部位。口干是口腔中最常见的药物不良反应。影响食管的药物不良反应包括黏膜刺激和炎症。所有食管炎病例中约三分之一是由非甾体抗炎药(NSAIDs)的使用引起的。涉及胃和小肠溃疡的主要原因是NSAIDs。药物性腹泻是最常见的不良反应,约占所有观察到的药物不良反应病例的7%。它们可能由抗生素、镁盐、泻药等引发。另一方面,某些药物组可能会导致便秘。这些药物包括阿片类药物、利尿剂、钙通道阻滞剂、胆碱能阻滞剂等。质子泵抑制剂、二甲双胍、奥利司他和考来维仑可能会导致某些维生素和矿物质的吸收受限。医生对最常见且有充分文献记载的药物不良反应的了解可以提高患者的安全性,并使药物治疗对他们来说更舒适。