Аннотация
Ингибиторы протонной помпы (ИПП) являются наиболее эффективными препаратами для лечения кислотозависимых заболеваний. В последние десятилетия использование ИПП растет в геометрической прогрессии. Долгое время ИПП считались полностью безопасными лекарственными веществами как для краткосрочного, так и для длительного применения. Однако в современных клинических рекомендациях отмечается, что при назначении ИПП в больших дозах на длительный срок следует учитывать возможность развития побочных эффектов. В отечественной литературе обзоры, посвященные вопросам безопасности ИПП при длительном применении, отсутствуют. В этой связи проведен поиск в информационных базах PubMed и Scopus публикаций, посвященных безопасности применения ИПП, включавший источники до 15.11.2023, показавший, что длительное применение ИПП связано с возможным развитием многочисленных побочных эффектов. В первых публикациях были рассмотрены вероятные побочные эффекты при долгосрочном применении ИПП: развитие инфекций, повышенный риск переломов и патология почек и возможные побочные эффекты: риск онкологических заболеваний и электролитные нарушения. В рамках данного обзора рассматривается возможный кардиоваскулярный риск длительного применения ИПП и ряд редких побочных эффектов, многие из которых описаны в последние годы. Ключом к смягчению побочных эффектов является рациональное применение ИПП в минимально эффективной дозе и в кратчайшие сроки. При наличии четких показаний к длительному назначению ИПП следует проводить мониторинг, направленный на выявление побочных эффектов.
Ключевые слова: ингибиторы протонной помпы, лекарственная безопасность, побочные эффекты, сердечно-сосудистый риск, неблагоприятные сердечно-сосудистые события, инфаркт миокарда, инсульт, деменция, эректильная дисфункция, сахарный диабет, бронхиальная астма, хроническая обструктивная болезнь легких.
Об авторе
Д.И. Трухан
ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия
dmitry_trukhan@mail.ru
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Для цитирования:Трухан Д.И. Лекарственная безопасность: в фокусе долгосрочная терапия ингибиторами протонной помпы. Возможный сердечно-сосудистый риск и редкие побочные эффекты. Клинический разбор в общей медицине. 2024; 5 (3): 111–118. DOI: 10.47407/kr2023.5.3.00380
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