@article{oai:niigata-u.repo.nii.ac.jp:00017285,
 author = {中野, 正明},
 issue = {7},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Jul},
 note = {Nonsteroidal anti-inflammatory drugs (NSAIDs) are now the most commonly prescribed agents in the treatment of rheumatic diseases because of their analgesic and anti-inflammatory properties. The major mechanism whereby NSAIDs achieve their anti-inflammatory effects has been shown to be the inhibition of prostaglandin (PG) biosynthesis. An increasing number of patients have developed serious complications from NSAIDs. This inhibition is documented to be a cause of adverse reactions of NSAIDs. Among these complications, we reviewed and discussed gastrointestinal (GI) and renal disorders in this symposium. Of 1008 Japanese RA patients taking NSAIDs, gastric ulcer was noticed in 15.5% of the cases. The high prevalence of GI injury in RA patients has been esteemed to be responsible for the use of NSAIDs. The following 4 types of drugs are known to be useful for prevention of NSAIDs-related GI mucosal damage：histamine-receptor antagonist；gastric acid pump inhibitor；barrier agents；and PG analogue. A PG analogue, misoprostol, was to be the most effective agent. Furthermore, NO-releasing NSAIDs, which were recently developed, may be able to reduce adverse reactions of GI tract. NSAIDs may cause renal disorders by different mechanisms, including reversible renal hypoperfusion, acute tubular necrosis, or acute tubulointerstitial nephritis with or without nephrotic syndrome. The long-term treatment with NSAIDs may produce a subclinical renal dysfunction. Furthermore, severe renal dysfunction are likely to develop in patients with poor perfusion. Irreversible renal failure may also develop in patients receiving other medications that may have contributed to renal dysfunction. Selective cyclooxygenase-2 inhibitors such as etodolac have shown the lower incidence of adverse reactions in GI tract and kidney than other conventional NSAIDs. Misoprostol can also minimize NSAIDs-induced renal dysfunction without affecting pain control.},
 pages = {429--432},
 title = {3)-1 消炎鎮痛薬(シンポジウム 薬剤の副作用, 第518回新潟医学会)},
 volume = {111},
 year = {1997}
}