课件：爱爱医资源-消化系统疾病常用药物.ppt

* pH6以上止血反应尚能较慢进行，pH6以下则显著受阻，CT为凝血时间。 上消化道出血初期，由于血液的缓冲作用，在血管破损的局部pH接近中性,有利止血，随着胃排空，局部酸度将逐渐升高，阻碍止血过程 。 * 治疗目标：一是胃内pH6以上，二是持续维持。因为任何泌酸反跳都可 能导致再出血发生而使治疗失败 * * Patient noncompliance is a fact of life supported by many studies. (1,2) Rabeprazole, with a rapid onset of action, potent acid inhibition on Day 1, an early maximal acid inhibitory effect, and early symptom relief would be ideal for patients who stop and start prescribed medication. In addition, rabeprazole’s properties make it ideal for “on demand” therapy. On demand therapy allows doctors to prescribe a new, highly convenient, and cost effective approach to the long-term maintenance of GERD healing. The key pharmacological property for a PPI that is suitable for on-demand treatment, is a rapid onset of acid inhibition. Rabeprazole’s onset of action within a few hours, maximal inhibition at 4 hours, potent Day 1 effect, and early symptom relief makes it suitable for on demand treatment. (3-5) 1. Levy RL, Feld AD. Increasing patient adherence to gastroenterology treatment and prevention regimens. Am J Gastroenterol. 1999;94:1733-1742. 2. Hungin AP, Rubin G, O’Flanagan H. Factors influencing compliance in long-term proton pump inhibitor therapy in general practice. Br J Gen Pract. 1999;49:463-464. 3. Gardner JD, Barth JA, Rodriquez-Stanley S, Robinson M. Maximal or near-maximal inhibition of esophageal acidity by the first dose of rabeprazole in GERD. Gastroenterology. 2000;118:A1237. Abstract. 4. Gardner JD, Sloan S, Barth JA. Onset, duration and magnitude of gastric antisecretory effects of rabeprazole and omeprazole. Am J Gastroenterol. 1999;94:A2608. Abstract. 5. Jokubaitis L, Murthy A, Hegedus R, Robinson M. Acute Symptom relief: the F.A.S.T. Trial. Am J Gastroenterol. 2000; (In Press). Abstract. 局部止血药物 去甲肾上腺素8mg加冰生理盐水100ml，分次口服， 去甲肾上腺8mg加冰盐水100ml中,自胃管内注入,待30～45分钟吸出后再灌注。 5.5%氢氧化铝凝胶20ml内口服,每日3～4次 HP与胃肠道四种疾病密切相关 1 .慢性活动性胃炎 2. 消化性溃疡 3. MALT淋巴瘤 4. 胃癌 幽门螺杆菌若干问题的共