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Virkni sýruhemjandi lyfja : samanburður á Losec/Lómex og Zantac/Famex : mæling á sýrustigi í maga í 24 klukkustundir

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Authors
Hallgrímur Guðjónsson
Einar Oddsson
Magdalena Sigurðardóttir
Bjarni Þjóðleifsson
Útgáfudagur
1997-06-01

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Önnur málmynd
Comparison of the efficacy of Losec/Lómex and Zantac/Famex by continuous 24 hour gastric pH-metry
Citation
Læknablaðið 1997, 83(6):368-73
Útdráttur
Objective: The study proposes to investigate the pharmacological efficacy of four commonly used acid inhibitory drugs. The effect on 24 hour gastric pH of seven days treatment was assessed for two omeprazole preparations, Losec® 20 mg (Hassle) and Lómex® 20 mg, (Omega Farma) and two H2 blockers, famotidine 40 mg (Famex®, Omega Farma) and ranitidine 300 mg (Zantac®, Glaxo). Material and methods: Sixteen healthy volunteers participated in each experiment comparing blindly Losec® / Lómex® and Famex® / Zantac®. The stomach was intubated with monocrystant antimony catheter and the pH sensor was placed 10 cm below the cardia. A 24 hour control pH-metry was performed followed by a 24 hour pH-metry on the seventh day of treatment with each drug. Results: All four drugs gave significant acid inhibition compared to control. Zantac treatment resulted in a pH over 3 for 8.8 hours and correspondingly Famex® treatment for 11.2 hours, Losec® treatment for 17.5 hours and Lómex® for 18.3 hours. Famex® gave significantly greater inhibition than Zantac® but the difference between Lómex® and Losec® was not significant. Conclusion: The study shows the efficacy of com¬monly used acid lowering drugs on the Icelandic market. The relative efficacy is indicated by the fact that Zantac® increased the median time for pH over 3 by 2.6 hours, Famex® by 5.0 hours, Losec® by 11.3 hours and Lómex® by 12.1 hours.
Markmið: Markmið rannsóknarinnar var að meta virkni fjögurra lyfja sem hækka sýrustig í maga. Bera hana saman við þá hækkun á sýrustigi sem nauðsynleg er til að ná fullri svörun í meðferð sýrutengdra sjúkdóma. Áhrif vikumeðferðar á sýrustig í maga í sólarhring, voru könnuð fyrir tvær ómeprazól lyfjagerðir, Losec® 20 mg (Hassle) og Lómex® 20 mg (Omega Farma) og tvo H2 blokka, famótidín 40 mg (Famex® Omega Farma) og ranitidin 300 mg (Zantac®, Glaxo). Aðferðir: Sextán heilbrigðir sjálfboðaliðar tóku þátt í þremur tilraunalotum. Í fyrstu lotu var gerð viðmiðunarmæling án lyfja. Í annarri lotu var gerð mæling á sjöunda degi meðferðar með Famex® og Zantac® og í þriðju lotu var gerð mæling á sjöunda degi meðferðar með Losec® og Lómex®. Tilviljun réði röð lyfja. Grönn slanga með sýruskynjara var þrædd í gegnum nef sjálfboðaliðanna og niður í maga. Sýruskynjari var staðsettur 10 cm neðan við mót maga og vélinda og sýrustig mælt í 24 klukkustundir. Niðurstöður: Öll lyfin hækkuðu sýrustigið marktækt miðað við viðmiðunarmælingu. Zantac® meðferð gaf gildi yfir 3 í 8,8 klukkustundir, Famex® í 11,2, Losec® í 17,5 og Lómex® gaf gildi yfir 3 í 18,3 klukkustundir. Famex® hækkaði sýrustig marktækt meira en Zantac® en ekki var munur á Lómex® og Losec®. Ályktun: Samanburður á virkni lyfjanna sést best á því að Zantac® lengdi tímann sem sýrustigið var yfir 3 um 2,6 klukkustundir, Famex® um fimm klukkustundir, Losec® um 11,3 og Lómex® um 12,1 klukkustund.
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