【病例学习第26期】Heliobacter pylori Eradication去除幽门螺杆菌

From Pharmacy Times(www.pharmacytimes.com)
Thanks to the author Craig I. Coleman, PharmD(Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.)

以下为正文(需要翻译的部分),欢迎会员认领并尽可能在48小时内翻译完毕并提交,将奖励50威望和50金钱.

Heliobacter pylori Eradication

HP is a 42-year-old man who comes to the pharmacy counter at a major grocery store pharmacy with prescriptions for clarithromycin 500 g twice daily, metronidazole 500 mg twice daily, and lansoprazole 30 mg twice daily for 14 days. HP had just come from his physician's office across the street, where he was told that he was infected with a bacterium called Helicobacter pylori. The pharmacist fills the prescription and starts to counsel HP on the importance of completing the entire course of antibiotic therapy when she notices a 6-pack of beer in HP's shopping cart.

What should the pharmacist do next? What would an alternative regimen contain?


ANSWER

It is very important that the pharmacist make HP aware that it can be extremely dangerous to drink alcohol while taking metronidazole, because the 2 can interact, resulting in severe nausea and vomiting, headache, abdominal cramps, flushing, and palpitations, and, in severe cases, may even be fatal (disulfiram-like reaction). HP should be told not to consume alcohol (including from cough and cold preparations) for at least 3 days after he has completed therapy. A number of 2-antibiotic regimens, along with a proton pump inhibitor or histamine-2 antagonist, have been studied to eradicate H pylori infections. Replacing the metronidazole in the above regimen with amoxicillin 1 g twice daily results in an effective and commonly used regimen referred to as CAP and is marketed under the brand name Prevpac.


去除幽门螺杆菌
HP 是一位42岁的男士，拿着一份处方来到了一个大型食品药品商店的药品柜台，处方为克拉霉素每天500mg每日两次，甲硝唑每次500mg每日两次，兰索拉唑每次30mg每日两次，共十四天。 HP刚刚从街对面的医生诊室那里来，在那里他被告知感染了名叫幽门螺杆菌的细菌。药师调配了处方并且当她注意到在HP的购物车中一个六瓶装的啤酒的时候，开始告诫HP完成整个抗生素治疗过程的重要性。
药师下一步应做什么呢？一个选择的用药法将包括什么呢？
回答
药师告知HP当服用甲硝唑时喝酒可能十分危险是非常重要的，因为两者可能有相互作用，导致严重的恶心和呕吐、头痛、胃部痉挛、面部胀红、心悸，而且，严重时可能致命（戒酒硫样反应）。HP应被告知至少在他完成治疗以后三天内不要使用含醇药品（包括咳嗽和感冒制剂）。大量的关于二联抗生素加一种质子泵抑制剂或组胺-2受体拮抗剂已经研究来除去幽门螺杆局感染。以上的药物治疗中用阿莫西林每次1g每日2次代替甲硝唑也是有效的， 一般服用市场销售名为“Prevpac”品牌的胶囊。

这段短，我来译吧。

除去幽门螺杆菌
HP 是一位42岁的男士，拿着一份处方来到了一个大型食品药品商店的药品柜台，处方为克拉霉素每天500mg每日两次，甲硝唑每次500mg每日两次，兰索拉唑每次30mg每日两次，共十四天。 HP刚刚从街对面的医生诊室那里来，在那里他被告知感染了名叫幽门螺杆菌的细菌。药师调配了处方并且当她注意到在HP的购物车中一个六瓶装的啤酒的时候，开始告诫HP完成整个抗生素治疗过程的重要性。
药师下一步应做什么呢？一个选择的用药法将包括什么呢？
回答
药师告知HP当服用甲硝唑时喝酒可能十分危险是非常重要的，因为两者可能有相互作用，导致严重的恶心和呕吐、头痛、胃部痉挛、面部胀红、心悸，而且，严重时可能致命（戒酒硫样反应）。HP应被告知至少在他完成治疗以后三天内不要使用含醇药品（包括咳嗽和感冒制剂）。大量的关于二联抗生素加一种质子泵抑制剂或组胺-2受体拮抗剂已经研究来除去幽门螺杆局感染。以上的药物治疗中用阿莫西林每次1g每日2次代替甲硝唑也是有效的， 一般服用市场销售名为“Prevpac”品牌的胶囊。

怎么不给加分，快加分吧。