« 高齢者の入院、どれだけはやく退院するべきか | メイン | 090828 MAC »

PPI使い方

PPI使い方
(「Clinician no. 576」より)
http://www.e-clinician.net/new.html

・NSAIDs、アスピリンの胃潰瘍予防に
・ワーファリンと併用すると、代謝経路が共通のため出血の危険を増す。PTをチェック
・PPIは、H2blockerと違い、PPIが食物などの刺激によって活性化しているほうが効果は高い。夕食後の服用がよい。眠前に飲まない
・分2内服のほうが効果増す
・日本人はピロリ感染率が高いため、胃粘膜委縮ある人が多い。それゆえ胃酸分泌は低下しているはず。 しかし、食事の欧米化とともにピロリ感染率は低下している
・防御系薬剤のほうが薬価が低く、酸分泌抑制で肺炎のリスクが高まったり骨折増加のリスクがあるとも報告ある。
・NSAID インドメタシンはラットに高率で小腸粘膜障害を引き起こす。また、胃・小腸の細菌叢を変化させる可能性がある(bacterial overgrowth, 偽膜性腸炎など)。IBSとの関連が示唆されている
・アスピリン腸溶錠はかえって小腸に粘膜障害を起こす、かもしれない
・逆流性食道炎に対するPPIの有効率は80%以上。しかし、GERDではその有効率は低下する。NERDではPPI抵抗性。
・口内崩壊錠よりも、小さな錠のほうが飲みやすいかも
・骨折リスクを上げる薬は、ステロイド、GnRHとその拮抗薬、アロマターゼ阻害薬、SSRI。PPIもそうかも。5年以上の内服で明らかにリスク増加

トラックバック

このエントリーのトラックバックURL:
http://dream-hosp.net/cgi/mt/mt-tb.cgi/2789

コメント

What a lovely day for a 4908036! SCK was here

What a lovely day for a 2996964! SCK was here

What a lovely day for a 494027! SCK was here

I am continuously browsing online for tips that can benefit me. Thanks!

What a lovely day for a 4482605! SCK was here

I would like to thnkx for the efforts you've put in writing this website. I'm hoping the same high-grade site post from you in the upcoming also. Actually your creative writing skills has inspired me to get my own blog now. Really the blogging is spreading its wings quickly. Your write up is a good example of it.

What a lovely day for a 1673419! SCK was here

I was just searching for this info for a while. After 6 hours of continuous Googleing, finally I got it in your site. I wonder what is the lack of Google strategy that don't rank this type of informative web sites in top of the list. Usually the top web sites are full of garbage.

Grand poteau ! Merci pour prendre le temps d'テゥcrire quelque chose qui est rテゥellement en valeur la lecture. Trop souvent je trouve l'information inutile et pas quelque chose qui sont rテゥellement appropriテゥes. Merci pour votre dur labeur.

I must say you have a cool post. This hit the spot and then some! Thanks for posting this and sharing it with the world. I've just bookmarked your site. And I will check back soon to read your other articles. Keep up your awesome work.

There may be noticeably a bundle to know about this. I assume you made sure nice factors in features also.

My brother recommended I might like this blog. He was totally right. This post actually made my day. You cann't imagine just how much time I had spent for this info! Thanks!

Thank you for sharing with us, I conceive this website really stands out : D.

I am glad to finally learn this. Thanks!

Thanks for sharing this first-class post. Very interesting ideas! (as always, btw)

Ha ha... I was just browsing around and took a look at these comments. I can't believe that there's still this much attention. Thanks for writing about this.

Many thanks for making the effort to talk about this, I feel strongly about this and enjoy studying a great deal more on this topic. If feasible, as you gain knowledge, would you mind updating your website with a great deal more details? It's really beneficial for me.

I was wondering if you ever considered changing the layout of your blog? Its very well written; I love what youve got to say. But maybe you could a little more in the way of content so people could connect with it better. Youve got an awful lot of text for only having one or two images. Maybe you could space it out better?

Ha ha... I was just online around and took a glimpse at these feedback. I can't believe there's still this much attention. Thanks for writing about this.

What a lovely day for a 4585159! SCK was here

Hmmm thanks for yet another very interesting post. Where do you receive your inspiration for all this :|?

You really make it seem so easy with your presentation but I find this topic to be actually something that I think I would never understand. It seems too complex and extremely broad for me. I am looking forward for your next post, I窶冤l try to get the hang of it!

pretty valuable stuff, overall I imagine this is worthy of a bookmark, thanks

Hey very nice website!! Man .. Beautiful .. Amazing .. I'll bookmark your blog and take the feeds also窶ヲI am happy to find so many useful info here in the post, we need work out more strategies in this regard, thanks for sharing. . . . . .

This blog appears to get a good ammount of visitors. How do you promote it? It gives a nice individual twist on things. I guess having something real or substantial to give info on is the most important thing.

Finally a smart blogger...I love how you're thinking and writing!

I commend the illuminating article you provide in your articles. I'll bookmark your blog and have my friends scrutiny up in your blog frequently.

This blog appears to get a large ammount of visitors. How do you advertise it? It gives a nice unique spin on things. I guess having something authentic or substantial to post about is the most important thing.

There are certainly a variety of particulars like that to take into consideration. That could be a nice point to deliver up. I offer the ideas above as normal inspiration but clearly there are questions like the one you bring up the place crucial thing will be working in honest good faith. I don?t know if greatest practices have emerged round issues like that, however I am certain that your job is clearly identified as a fair game. Both girls and boys feel the affect of just a second窶冱 pleasure, for the rest of their lives.

Keep functioning ,great job!

Smashing Blog. I count up this Blog to my bookmarks.Thanks for taking the tempo to examine this, I lean to strongly approximately it and light of one's life information more on this topic.

magnificent points altogether, you just gained a new reader. What would you recommend in regards to your post that you made some days ago? Any positive?

I like to visit your site a span times a week in compensation advanced thoughts. I was wondering if you bring into the world any other topics you send a letter about?

You must participate in a contest for probably the greatest blogs on the web. I'll advocate this site!

My brother suggested I might like this website. He was totally right. This post actually made my day. You can not imagine simply how much time I had spent for this info! Thanks!

My brother suggested I might like this blog. He was entirely right. This post actually made my day. You can not imagine just how much time I had spent for this info! Thanks!

Pretty nice post. I just stumbled upon your blog and wanted to say that I have truly enjoyed surfing around your blog posts. After all I will be subscribing to your feed and I hope you write again very soon!

I used to be more than happy to search out this web-site.I wanted to thanks on your time for this glorious read!! I positively having fun with each little bit of it and I have you bookmarked to take a look at new stuff you blog post.

Why on earth do you say something like this?

Your blog has made me think about an issue from another context. This is quite rare when I change my idea about such subjects but it looks that you窶况e done it. The day has begin with something new! Thank you!

The site was dull. Everyday living goes on.

Several of these comments are junk; You might want to get rid of them.

Some of these replies are junk; You might want to filter them out. The article is incredibly dull. Daily life goes on.

Seems it is pretty energetic right here. Several of these comments appear to be junk, You should filter them out.

You should participate in a contest for one of the best blogs on the web. I will suggest this web site!

Unquestionably believe that which you said. Your favorite reason appeared to be on the net the easiest thing to be aware of. I say to you, I certainly get irked while people consider worries that they plainly do not know about. You managed to hit the nail upon the top as well as defined out the whole thing without having side-effects , people can take a signal. Will likely be back to get more. Thanks

Hi my friend! I wish to say that this article is amazing, nice written and include almost all vital infos. I窶囘 like to see more posts like this .

A powerful share, I just given this onto a colleague who was doing somewhat evaluation on this. And he in truth bought me breakfast as a result of I discovered it for him.. smile. So let me reword that: Thnx for the deal with! However yeah Thnkx for spending the time to debate this, I feel strongly about it and love studying extra on this topic. If attainable, as you become expertise, would you mind updating your blog with extra details? It's highly useful for me. Big thumb up for this blog post!

Seems to be pretty active around here

Youre so cool! I dont suppose Ive learn something like this before. So good to search out someone with some unique ideas on this subject. realy thanks for beginning this up. this web site is one thing that is wanted on the internet, somebody with somewhat originality. useful job for bringing one thing new to the internet!

I'm usually to blogging and i really recognize your content. The article has actually peaks my interest. I'm going to bookmark your site and maintain checking for new information.

Some of these replies look like junk. You might want to filter them out.

I窶囘 be inclined to concede with you here. Which is not something I typically do! I love reading a post that will make people think. Also, thanks for allowing me to speak my mind!

My spouse and i must articulate a guide is simply remarkable that leave people learned quite a few items report. Manged to get enough ideas in my mind then. Thanks for this process. I think you will will keep intending combined with remain distribute great new guidance that individuals how to start yet.

You窶决e blogging has really come on when I look back over previous posts. Actually I arrived here from a forum on an unrelated topic. Worth surfing sometimes. Thanks.

I have not checked in here for some time since I thought it was getting boring, but the last few posts are good quality so I guess I窶冤l add you back to my everyday bloglist. You deserve it friend :)

Seems to be fairly active right here

Anyway i must exclaim your commentary is definitely great that leave my family self taught themselves numerous items trends. I bought numerous perception i believe finally. Very good this approach. I think you'll can continue about as well as stay reveal fresh new tips that have no idea of nevertheless.

This blog seems to get a sizable ammount associated with site visitors. How do you obtain visitors to this? It gives a nice individual distort on things. I guess getting something authentic or substantial to provide info on is the most important element.

Nice read, I just passed this onto a colleague who was doing some research on that. And he just bought me lunch since I found it for him smile Thus let me rephrase that: Thank you for lunch!

Aw, this was a very nice post. In concept I would like to put in writing like this moreover 窶 taking time and actual effort to make a very good article窶ヲ however what can I say窶ヲ I procrastinate alot and in no way seem to get something done.

コメントを投稿