Affiliation:
1. Almazov National Medical Research Center
Abstract
The high prevalence of cardiovascular disease and its frequent pathogenetic relationship with various comorbid diseases and conditions lead to polypragmasia and the development of undesirable adverse reactions. Treatment premorbidly disorders requires high clinical expertise and breadth of knowledge in the field of related disciplines that allows you to efficiently prescribe the appropriate drug therapy. It is important to emphasize that a patient with cardiovascular disease often receives antiplatelet therapy, including double, which can lead to adverse reactions from the upper gastrointestinal tract (due to the peculiarities of the mechanism of action of antiplatelet drugs), including from the esophagus, provoking the development or deterioration of gastroesophageal reflux disease (GERD). Proton pump inhibitors (PPI) are used for the prevention and treatment of these adverse events on the part of the gastrointestinal tract. Effective drug therapy for GERD also includes the administration of these drugs. However. Given the polymorbidity of patients and polypragmasia, the practitioner should strive to prescribe drugs with the lowest risk of drug interactions. These requirements are met by PPI rabeprazole, the metabolism of which is predictable. The use of this drug is presented in a clinical case.
Reference19 articles.
1. Vertkin A.L., Rumyantsev M.A., Skotnikov A.S. Comorbidity. Klinicheskaya meditsina = Clinical medicine. 2012;10:4–11. (in Russ.) Available at: https://elibrary.ru/item.asp?id=18756166.
2. Oganov R.G., Simanenkov V.I., Bakulin I.G., Bakulina N.V., Barbarash O.L., Boytsov S.A., Boldueva S.A., Garganeeva N.P., Doshchitsin V.L., Karateev A.E., Kotovskaya Y.V., Lila A.M., Lukyanov M.M., Morozova T.E., Pereverzev A.P., Petrova M.M., Pozdnyakov Y.M., Syrov A.V., Tarasov A.V., Tkacheva O.N., Shalnova S.A. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2019;18(1):5-66. (In Russ.) doi: 10.15829/1728-8800-2019-1-5-66.
3. Evdokimova A.G., Evdokimov V.V. Cardiocerebral dysfunction: risk factors and possibilities of cytoprotective therapy. Effektivnaya farmakoterapiya. Kardiologiya i angiologiya = Effective Pharmacotherapy. Cardiology and Angiology. 2013;(1):6–10. (in Russ.) Available at: http://umedp.ru/articles/kardiotserebralnaya_disfunktsiya_faktory_riska_i_vozmozhnosti_tsitoprotektivnoy_terapii.html.
4. Lansberg M.G., O’Donnell M.J., Khatri P., Lang E.S., Nguyen-Huynh M.N., Schwartz N.E., Sonnenberg F.A., Schulman S., Vandvik P.O., Spencer F.A., Alonso-Coello P., Guyatt G.H., Akl E.A. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed.: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2)(Suppl.):e601S-e636S. doi: 10.1378/chest.11-2302.
5. Garcia Rodriguez L.A., Johansson S., Cea Soriano L. Use of clopidogrel and proton pump inhibitors after a serious acute coronary event: risk of coronary events and peptic ulcer bleeding. Thromb Haemost. 2013;110(5):10141024. doi: 10.1160/TH13-03-0225.