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Abstract(s)
A úlcera é uma patologia que atinge o trato gastrointestinal surgindo, mais
frequentemente, no estômago e duodeno proximal. Caracteriza-se pela presença de
lesões na mucosa gastrointestinal que podem ser originadas por inúmeros fatores sendo
os de maior importância a infeção por Helicobacter Pylori (H. pylori), Anti-inflamatórios
não esteróides (AINEs) e hábitos tabágicos.
Dependendo da causa subjacente, o tratamento da úlcera gástrica passa pela
utilização de antibioterapia quando de origem infecciosa, suspensão da utilização de
AINEs e controlo da secreção de ácido clorídrico com utilização de inibidores da bomba
de protões. São ainda utilizados outros fármacos como o sucralfato, bismuto, análogos
das prostaglandinas e neutralizadores da secreção ácida que auxiliam no esquema
terapêutico, contribuindo para a proteção da mucosa gástrica, erradicação do agente
infeccioso e/ou alívio da sintomatologia.
Os probióticos têm ganho uma importância cada vez maior tendo demonstrado
vantagens na sua utilização em doentes com úlcera gástrica. Estão ainda referenciados
como potenciais vetores na elaboração da vacina contra H.pylori.
Sendo a polimedicação uma realidade cada vez mais frequente na atualidade, o
doente com úlcera gástrica requer uma atenção redobrada. O comprometimento da
função normal da mucosa gástrica tem um elevado impacto na cinética dos fármacos
sendo ainda necessário ter em conta os efeitos indesejáveis dos mesmos. Assim, existem
estudos que comprovam a existência de benefícios na utilização de inibidores da enzima
de conversão da angiotensina em doentes hipertensos com úlcera gástrica aguda ou
crónica. Em doentes diabéticos, a metformina demonstrou ter vantagens em doentes
com úlcera gástrica causada por H. pylori. Já em doentes com hiperlipidémia, as
estatinas e os fibratos foram os que evidenciaram maiores benefícios.
O farmacêutico é muito frequentemente o primeiro profissional de saúde a que
os utentes recorrem e por isso essencial na identificação de comportamentos de risco e
sintomas de úlcera gástrica.
Ulcer is a pathology that affects the gastrointestinal tract, most often appearing in the stomach and proximal duodenum. It is characterized by the presence of lesions in the gastrointestinal mucosa that can be caused by numerous factors, the most important are infection with Helicobacter Pylori (H. pylori), non-steroidal antiinflammatory drugs (NSAIDs) and smoking habits. Depending on the underlying cause, the treatment of gastric ulcer involves the use of antibiotic when of the cause is infectious, suspension of the use of NSAIDs and control of hydrochloric acid secretion with the use of proton pump inhibitors. Other drugs such as sucralfate, bismuth, prostaglandin analogues and acid secretion neutralizers are also used, which help in the therapeutic regimen, contributing to the protection of the gastric mucosa, eradication of the infectious agent and/or relief of symptoms. Probiotics have gained increasing importance and have shown advantages in their use in patients with gastric ulcer. They are also mentioned as potential vectors in the elaboration of the vaccine against H.pylori. As polymedication is an increasingly frequent reality today, the patient with gastric ulcer requires increased attention. The impairment of the normal function of the gastric mucosa has a high impact on the kinetics of drugs and it is still necessary to take into account their undesirable effects. Thus, there are studies that prove the existence of benefits in the use of angiotensin converting enzyme inhibitors in hypertensive patients with acute or chronic gastric ulcer. In diabetic patients, metformin has been shown to have benefits in patients with gastric ulcer caused by H. pylori. In patients with hyperlipidemia, statins and fibrates showed the greatest benefits. The pharmacist is very often the first health professional that population turn to and therefore essential in the identification of risk behaviors and symptoms of gastric ulcer.
Ulcer is a pathology that affects the gastrointestinal tract, most often appearing in the stomach and proximal duodenum. It is characterized by the presence of lesions in the gastrointestinal mucosa that can be caused by numerous factors, the most important are infection with Helicobacter Pylori (H. pylori), non-steroidal antiinflammatory drugs (NSAIDs) and smoking habits. Depending on the underlying cause, the treatment of gastric ulcer involves the use of antibiotic when of the cause is infectious, suspension of the use of NSAIDs and control of hydrochloric acid secretion with the use of proton pump inhibitors. Other drugs such as sucralfate, bismuth, prostaglandin analogues and acid secretion neutralizers are also used, which help in the therapeutic regimen, contributing to the protection of the gastric mucosa, eradication of the infectious agent and/or relief of symptoms. Probiotics have gained increasing importance and have shown advantages in their use in patients with gastric ulcer. They are also mentioned as potential vectors in the elaboration of the vaccine against H.pylori. As polymedication is an increasingly frequent reality today, the patient with gastric ulcer requires increased attention. The impairment of the normal function of the gastric mucosa has a high impact on the kinetics of drugs and it is still necessary to take into account their undesirable effects. Thus, there are studies that prove the existence of benefits in the use of angiotensin converting enzyme inhibitors in hypertensive patients with acute or chronic gastric ulcer. In diabetic patients, metformin has been shown to have benefits in patients with gastric ulcer caused by H. pylori. In patients with hyperlipidemia, statins and fibrates showed the greatest benefits. The pharmacist is very often the first health professional that population turn to and therefore essential in the identification of risk behaviors and symptoms of gastric ulcer.
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Keywords
Estômago Trato gastrointestinal Úlcera péptica Helicobacter pylori Anti-inflamatórios não esteróides Inibidores da bomba de protões