Patient with polymyalgia rheumatica — how to prevent gastrointestinal damage?

Abstract

Basis. The problem of multimorbidity and related polypragmasia is highly relevant for health practitioners. Providing treatment a doctor should keep in mind itsall possible negative consequences that might exacerbate other diseases. One of the most current problems of modern pharmacotherapy is the development of gastropatia and other gastrointestinal lesions because of drug intake. It is extremely important for rheumatologic patients, especially elderly ones, due to side effects of nonsteroidal anti-inflammatory drugs and glucocorticoids. Reasonable approach to the prescription of this therapy and side effects prevention is a significant factor of the preventive work of the therapist and the general practitioner of the outpatient service. In patients with rheumatic polymyalgia we showed an approach to long-term treatment of corticosteroids in elderly patients, the aim of which is to achieve a stable remission of the disease and to minimize the undesirable effect of the medication on the gastrointestinal tract.Aim. Provide an algorithm for the approach to identifying the risk factors of medicinal gastrointestinal lesions and methods for their prevention.Material and methods. We analyzed literature sources, including Russian guidelines over the last 10 years.Results. In the article we present an algorithm for detecting the risk of developing gastrointestinal tract lesions against the background of corticosteroid therapy in elderly patients and ways of preventing it.Conclusion. The prevention of unwanted drug reactions is an important aspect of a doctor’s work, especially in the treatment of elderly patients. The presented algorithm for identification of risk groups and prevention of side effects is intended to help the practical doctor in working with this category of patients.