著者

中村 浩規 横山 晴子 矢口 武廣 鈴木 優司 徳岡 健太郎 渡邊 昌之 北川 泰久 山田 安彦

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.131, no.3, pp.445-452, 2011-03-01 (Released:2011-03-01)

参考文献数

15

被引用文献数

4 4

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In this study, we investigated the effect of histamin H2 receptor antagonist (H2RA) or proton pump inhibitor (PPI) for the prevention of upper gastrointestinal lesions associated with low-dose aspirin. We carried out a retrospective study of 2811 patients who had been prescribed low-dose aspirin (Bayaspirin® 100 mg) for more than 30 days at Tokai University Hachioji Hospital from 2006 to 2008. We classified them into three groups: aspirin alone group (n=1103), aspirin with H2RA group (n=844) and aspirin with PPI group (n=864). Patients who developed upper gastrointestinal lesions were diagnosed with gastric ulcer, duodenal ulcer, gastritis or duodenitis by gastroscopy. We then compared the incidence of upper gastrointestinal lesions among the groups. The incidence in aspirin alone group, aspirin with H2RA group and aspirin with PPI group was 2.54%, 1.54% and 1.04%, respectively; that of aspirin with PPI group being significantly lower (p<0.05). Additively, the odds ratio (OR) of aspirin with H2RA group and aspirin with PPI group was 0.60 (95% confidence interval [95%CI]: 0.31-1.17) and 0.40 (95% CI: 0.19-0.86) as compared with aspirin alone group, respectively. The upper gastrointestinal lesions were developed within two years in all groups. Our results suggest that the combined administration of low-dose aspirin and PPI is effective for the prevention of upper gastrointestinal lesions associated with low-dose aspirin. Also, the pharmacists should be especially careful for upper gastrointestinal lesions development within two years after administration of low-dose aspirin, regardless of combined whether H2RA or PPI.

著者

鈴木 優司 横山 晴子 添田 真司 徳岡 健太郎 渡邊 昌之 北川 泰久 山田 安彦

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

pp.13-00193, (Released:2014-01-18)

参考文献数

11

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Low-dose aspirin-induced gastrointestinal lesions are becoming an important problem in clinical practice. In our investigation of such adverse effects, we obtained 4 important findings considered useful for physicians, as follows; 1) even when aspirin was given at a dose, the incidence rate of gastrointestinal lesions was higher than with other NSAIDs, 2) the odds ratios for gastrointestinal lesions induced by aspirin with a histamine H2 receptor antagonist and proton pump inhibitor were 0.6 and 0.4, respectively, as compared with aspirin alone, 3) it is difficult to administer aspirin, which exerts an antiplatelet effect, without inducing gastrointestinal lesions, and 4) these gastrointestinal lesions appears early, especially within 2 years after administration. We distributed a questionnaire to 41 physicians to confirm our findings, and compared high (n=20) and low (n=21) frequency aspirin prescription groups. The recognition rate of points 1 and 3 noted above in the high group was significantly elevated as compared to the low group, whereas there no significant difference in regard to the information in point 4 between the groups and the rate of recognition was low. Moreover, only 27% of the surveyed physicians were familiar with all 4 points. Prior to receiving this information, 17% of the physicians gave no related instructions their patients, which was reduced to 0% after receiving this information. Furthermore, 98% of those surveyed found the information to be useful. Our results suggest that these 4 points of information regarding potential adverse gastrointestinal effects of low-dose aspirin are useful for physicians.

著者

吉崎 浩一 野瀬 弘之 鈴木 優司 近藤 則央 前田 淳一 堀井 修 飯井 サト子 牧村 士郎 寺井 継男 東 弘志

出版者

一般社団法人 日本農村医学会

雑誌

日本農村医学会雑誌 (ISSN:04682513)

巻号頁・発行日

vol.48, no.4, pp.630-637, 1999-11-30 (Released:2011-08-11)

参考文献数

5

被引用文献数

1 1

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上部消化管造影検査で高濃度バリウムを使用するにあたっての前調査として, バリウム飲用による副作用及びその服用感がバリウム濃度及びその性状によりどのように変化するかアンケート調査を行い検討した。副作用は, バリウム濃度上昇に伴い増加したが, 何れも一過性のものであり, 医療機関で治療を要した例はなかった。さらに, 便秘群と通常群に分けて検討したが, 便秘群では通常群より低い濃度で副作用の割合が増え, 排泄状況に関しても便の硬化や排泄の遅延などが認められた。バリウム便の排泄は, 基本的には普段の排便状況と一致し, 濃度増加による影響をあまり受けないものと思われた。下剤の有無による排便状況の調査では, 下剤の服用が必ずしも良好な排泄につながっておらず, 今後下剤を服用するタイミングや水分摂取等に関する検討が必要であると思われた。バリウムの飲み易さは, バリウムを選択する際の要素の一つと考えられるため, その服用感に関して調査したが, 濃度の差よりその性状に起因することが明らかになった。これらの結果より高濃度バリウムを使用するに当たり, 副作用出現を抑制するためには特に便秘群において適切な指導をする必要があると思われた。