gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2016-26-3-87-92gastro-j-63Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSК вопросу о безопасности приема ингибиторов протонной помпыSafety of proton pump inhibitorsЛосикЕ. А.LosikYe. A.kollezion@yandex.ruГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова»РоссияState educational government-financed institution of higher professional education «Sechenov First Moscow state medical university»Russian Federation2016120820162638792Copyright © Лосик Е.А., 20162016Лосик Е.А.Losik Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/63

Цель обзора. Рассмотреть последние данные о возможных механизмах развития побочных эффектов ингибиторов протонной помпы (ИПП). Основные положения. Ингибиторы протонной помпы представляют собой класс препаратов, которые блокируют H+/K+-АТФазу париетальных клеток желудка. В связи с этим они широко применяются у пациентов с кислотозависимыми заболеваниями верхних отделов желудочно-кишечного тракта. Короткие курсы ИПП переносятся пациентами хорошо и редко вызывают побочные эффекты. Рассматривается возможность развития дефицита железа, витамина В12, магния при длительном их приеме. Особый интерес представляет взаимосвязь между приемом ИПП и развитием остеопороза. Описаны случаи острого интерстициального нефрита, ассоциированного с терапией ИПП. Дискутабельным остается вопрос об увеличении риска развития кишечных инфекций, C. difficile-ассоциированной болезни, а также спонтанного бактериального перитонита у пациентов с циррозом печени. Заключение. Большинство побочных эффектов развивается у лиц старшей возрастной группы и с наличием фоновых заболеваний. Таким образом, ИПП могут расцениваться лишь как дополнительный фактор риска, а перед началом длительного лечения необходимо взвешивать все pro et contra.

Aim of review. To present modern data on the possible mechanisms of development of side effects of the proton pump inhibitors (PPI). Summary. Proton pump inhibitors is the class of pharmaceuticals that block N+/K+-ATPase of gastric parietal cells. In this regard they are widely applied in acid-related diseases of upper gastro-intestinal tract. Short term intake of PPI is well tolerated by patients and can rarely cause side effects. The risk of development of iron deficiency, vitamin B12, magnesium is discussed. The interrelation between PPI intake and osteoporosis development is of special interest. Cases of the PPIassociated acute interstitial nephritis are presented. The risk of intestinal infections development, C. difficileassociated disease, and spontaneous bacterial peritonitis in liver cirrhosis patients are still under discussion. Conclusion. The majority of side effects develops in elderly patients have and concomitant diseases. Thus, PPIs can be considered only as supplementary risk factor, and before onset of the long-term treatment all pro et contra consideration should be evaluated.

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The authors declare that there are no conflicts of interest present.