Oštećenja gastrointestinalnog sustava uzrokovana lijekovima

master's thesis

• Title (english): Drug-induced gastrointestinal injuries
• Author: Petra Marinić
• Mentor: Anna Mrzljak (mentor)
• Committee member: Ingrid Prkačin (predsjednik povjerenstva)
• Committee member: Marko Jakopović (član povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Pharmacology

Abstract

Oštećenje gastrointestinalnog trakta uzrokovano lijekovima česta je pojava. Ovakvu vrstu ozljede mogu uzrokovati brojni lijekovi, a klinička manifestacija ovih oštećenja je raznolika te može varirati od benignih ozljeda do teških komplikacija kao što je krvarenje ili perforacija crijeva. Oštećenje jednjaka najčešće se prezentira ezofagitisom, pri čemu se endoskopski mogu uočiti upalne promjene, erozije i ulceracije. Osobita sklonost oštećenju lijekovima postoji kod osoba s poremećajem motiliteta, kardiomegalijom te mehaničkom zaprekom, npr. stenozom jednjaka ili tumorom. Lijekovi koji oštećuju želudac dovode do reaktivne gastropatije, erozija, ulkusa i perforacije. Lijekovi koji najviše oštećuju želudac su nesteroidni antiinflamatorni lijekovi zbog njihove široke, ali i dugoročne primjene. Međutim, brojni drugi lijekovi imaju svoj učinak na želučanu sluznicu. Nepovoljni učinci lijekova najčešće se javljaju u tankom i debelom crijevu. Simptomi oštećenja tankog crijeva često su blagi i nespecifični, međutim izazovi vezani uz pregled tankog crijeva otežavaju dijagnostiku. Ujedno, brojni lijekovi povezani su s oštećenjem kolona, a mehanizmi oštećenja su različiti bilo da mijenjaju normalnu floru i potiču infekcije, ili dovode do tromboza i ishemije. Cilj ovog preglednog rada je prikazati i sažeti dosadašnja saznanja o učinku određenih lijekova na gastrointestinalni sustav te prikazati njihove kliničke, endoskopske i histološke značajke.

Abstract (english)

The damage of gastrointestinal tract caused by drugs is a common occurence. This type of injury can be caused by numerous medications. The clinical manifestation of these damages may vary from benign injury to severe complications such as bleeding or perforation of the intestine. Esophageal injury is most commonly presented with esophagitis, where inflammatory changes, erosions and ulcers whose depth may vary can be detected endoscopically. There is a particular predisposition to drug damage in people with motility disorder, cardiomegaly, and mechanical obstruction, eg. esophageal stenosis or tumor. Drugs that damage the stomach lead to reactive gastropathy, erosions, ulcers and perforation. Drugs that damage the stomach the most are nonsteroidal antiinflammatory drugs due to their wide but also long-term applications. However, many other drugs have an effect on the gastric mucosa. Adverse drug effects usually occur on small and large intestine. The symptoms of small intestine damage are often mild and nonspecific, but the challenges associated with examining the small intestine make it difficult to diagnose. At the same time numerous drugs are associated with colon damage and the mechanisms of damage are different either by changing the normal flora and inducing infection, or leading to thrombosis and ischemia. The aim of this review is to present and summarize the current knowledge of the effects of certain drugs on the gastrointestinal system and to show their clinical, endoscopic and histological features.

• Keywords: lijekovi; nuspojave; gastrointestinalni sustav
• Keywords (english): drugs; side effects; gastrointestinal system
• Language: croatian
• URN:NBN: urn:nbn:hr:105:243997
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-19 12:19:30