Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3367510.26442/00403660.2019.08.000228Editorial articleПередовая статьяReview ArticleGastroesophageal reflux disease and esophagitis associated with the use of drugs: the modern state of the problemГастроэзофагеальная рефлюксная болезнь и эзофагит, ассоциированные с применением лекарственных препаратов: современное состояние проблемыOsadchukA MОсадчукАлексей Михайлович

д.м.н., проф. каф. госпитальной терапии с курсами поликлинической терапии и трансфузиологии ФГБОУ ВО «СамГМУ»; тел.: +7(927)606-09-40; e-mail: maxlife2004@mail.ru; ORCID: 0000-0002-8488-9235

maxlife2004@mail.ruDavydkinI LДавыдкинИгорь Леонидович

д.м.н., проф., зав. каф. госпитальной терапии с курсами поликлинической терапии и трансфузиологии ФГБОУ ВО «СамГМУ»; ORCID: 0000-0003-0645-7645

GricenkoT AГриценкоТарас Алексеевич

к.м.н., доц. каф. госпитальной терапии с курсами поликлинической терапии и трансфузиологии, врач-гематолог первого гематологического отделения клиник ФГБОУ ВО «СамГМУ»; ORCID: 0000-0002-2794-5122

OsadchukM AОсадчукМихаил Алексеевич

д.м.н., проф., зав. каф. поликлинической терапии лечебного факультета ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова»; ORCID: 0000-0003-0485-6802

Samara State Medical UniversityФГБОУ ВО «Самарский государственный медицинский университет» Минздрава РоссииSechenov First Moscow State Medical University (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)15082019918VOL 91, NO8 (2019)ТОМ 91, №8 (2019)13514016042020Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/33675

From the standpoint of evidence - based medicine, the ability of various drugs to induce the development of gastroesophageal reflux disease and esophagitis is considered. Thus, all known drugs can be divided into 3 groups: drugs that have the ability to reduce pressure in the lower esophageal sphincter, for example, β-adrenoreceptor agonists, α-adrenoreceptor antagonists, anticholinergics, calcium channel blockers, nitrates, benzodiazepines (diazepam), estrogen, progesterone, aminophylline (theophylline), tricyclic antidepressants, selective serotonin reuptake inhibitors, glucocorticosteroids; means providing a direct damaging effect on the esophageal mucosa, as well as lowering its resistance reflyuktatu, e.g., bisphosphonates, acetylsalicylic acid / non - steroidal anti - inflammatory agents, anticoagulants, antiplatelet drugs, iron preparations, ascorbic acid, potassium chloride, quinidine, phenytoin, calcium dobesilate, 131I sodium iodide, antibiotics (tetracycline, doxycycline, clindamycin, ciprofloxacin, ornidazole, clindamycin, rifampicin), antitumor agents; drugs that impede gastric emptying: calcium channel blockers, anticholinergics. These data can be used in practice in the choice of treatment tactics, especially in individuals with a diagnosis of gastroesophageal reflux disease or heartburn.

С позиции доказательной медицины рассмотрена способность различных медикаментозных препаратов индуцировать развитие гастроэзофагеальной рефлюксной болезни и эзофагита. Так, все известные лекарства условно можно разделить на три группы: лекарственные средства, обладающие способностью снижать давление в нижнем пищеводном сфинктере, например агонисты β-адренорецепторов, антагонисты α-адренорецепторов, антихолинергические средства, блокаторы кальциевых каналов, нитраты, бензодиазепины (диазепам), эстроген, прогестерон, аминофиллин (теофиллин), трициклические антидепрессанты, селективные ингибиторы обратного захвата серотонина, глюкокортикостероиды; средства, оказывающие прямое повреждающее действие на слизистую оболочку пищевода, а также снижающие ее резистентность к рефлюктату, например бифосфонаты, ацетилсалициловая кислота / нестероидные противовоспалительные средства, антикоагулянты, антиагреганты, препараты железа, аскорбиновая кислота, хлорид калия, хинидин, фенитоин, кальция добезилат, натрия йодид с 131I, антибиотики (тетрациклин, доксициклин, клиндамицин, ципрофлоксацин, орнидазол, клиндамицин, рифампицин), противоопухолевые средства; препараты, затрудняющие опорожнение желудка: блокаторы кальциевых каналов, антихолинергические средства. Приведенные данные могут найти применение в практической деятельности при выборе тактики лечения, прежде всего, у лиц с установленным диагнозом гастроэзофагеальной рефлюксной болезни или изжогой.

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