奥美拉唑的合理应用及不良反应分析

Rational Use and Control of Adverse Drug Reactions of Omeprazole

目的分析奥美拉唑的特性和临床合理应用案例,为控制该药不良反应的发生提供参考。方法对近几年有关奥美拉唑的最新应用进展、不良反应文献资料进行综述。结果奥美拉唑临床合理应用可治疗消化性溃疡、幽门螺杆菌感染、反流性食管炎、消化道出血、消化不良、卓-艾综合征(胃泌素瘤)、急性胰腺炎等疾病。其常见的不良反应有:胃肠道反应、维生素B12缺乏、肝脏和肾脏毒性、对神经系统的损伤、对视觉的损伤、对皮肤的影响、对内分泌系统的影响、自身免疫综合征、高胃泌素血症等。少见不良反应为过敏反应、心动过速、消化道出血、白细胞减少、特发性水肿、致类瘤形成、急性尿潴留、严重脱发、牙龈肿痛等。结论通过对奥美拉唑药动学、药效学性质,化学配伍、药物相互作用等进行分析,提示奥美拉唑可治疗与胃酸分泌有关的各种紊乱性疾病,其合理应用是减少、降低临床不良反应发生率的根本。

Objective To analyze characteristics of omeprazole and cases of its reasonable application so as to provide references for control of its adverse reactions. Methods The latest literature about the progress in clinical application and adverse reactions of omeprazole were reviewed. Results Omeprazole can treat peptic ulcer, infection of Helicobacter pylori, reflux esophagitis, hemorrhage of digestive tract, indigestion, Zollinger Ellison syndrome, acute panereatitis and so on. The common adverse reactions are gastroenteric reaction, lack of vitamin B12, liver and kidney toxicity, autoimmune syndrome, hypergastrinemia and damage to nervous system and vision, influence on skin and endocrine system. This drug canalso cause some unusual effects, such as allergic reactions, tachycardia, hemorrhage of digestive tract, leukopenia, idiopathic edema, carcinoid tumor formation, acute urinary retention, severe lipsotrichia, gingival swelling and pain. Conclusion The analysis on pharmacokinetics, pharmacodynamics, chemical compatibility and drug-drug interactions indicated that omeprazole can treat various disorders related to acid. The reasonable application of omeprazole is essential to reduce occurrence of adverse reactions.