111年第二次藥物治療學解析32

32.下列何者為治療NSAIDs引發消化性潰瘍的首選？

A.dinoprostone

B.famotidine

C.lansoprazole

D.misoprostol

答案C

解答：

1.根據UpToDate

https://www.uptodate.com/contents/peptic-ulcer-disease-treatment-and-secondary-prevention?search=peptic%20ulcer%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H903407570

Peptic ulcer disease: Treatment and secondary prevention

Choice of therapy — All patients with peptic ulcers should receive antisecretory therapy with a proton pump inhibitor (PPI) (eg, omeprazole 20 to 40 mg daily or equivalent) to facilitate ulcer healing (algorithm 1 and table 1). PPI use results in faster control of peptic ulcer disease symptoms and higher ulcer healing rates as compared with H2RA(H2-receptor antagonists) as a consequence of stronger acid suppression. PPIs also heal NSAID-related ulcers more effectively as compared with H2RAs

2. 參照Applied Therapeutics: The Clinical Use of Drugs (11 Edition)

Misoprostol reduces the risk of NSAID-induced gastric and duodenal ulcers, as well as the risk of upper GI complications in high-risk patients. Initially, the recommended dosage was 200 mcg 4 times a day, but diarrhea and abdominal cramping limited its use. (Misoprostol的可能副作用限縮了使用空間)

A: Dinoprostone 為Prostaglandin E2

B: famotidine 為H2-receptor antagonists(H2RA)

C: lansoprazole 為Proton pump inhibitor(PPI)

D: misoprostol 為Prostaglandin E1

故答案C為首選