Gastroesophageal reflux disease proton pump inhibitors

Proton pump inhibitors (PPIs), such as omeprazole, esomeprazole, lansoprazole, pantoprazole, and rabeprazole, are commonly prescribed to treat symptoms of heartburn, acid reflux, chest pain, dyspepsia, and chronic cough. PPIs inhibit the transfer of protons into the stomach lumen. Pharmacological acid suppression is thus used to treat gastroesophageal reflux disease (GERD) and esophagitis, peptic ulcers, and Helicobacter pylori infection as well as to prevent ulcer development with concurrent nonsteroidal anti-inflammatory drug use. 

Omeprazole (p. 167) can cause maximal inhibition of HCl secretion. Given orally in gastric juice-resistant capsules, it reaches parietal cells via the blood. In the acidic milieu of the mucosa, an active metabolite is formed and binds covalently to the ATP-driven proton pump (H+/K+ ATPase) that transports H+ in exchange for IC into the gastric juice. Lansoprazole and pantoprazole produce analogous effects. The proton pump inhibitors are first-line drugs for the treatment of gastroesophageal reflux disease. 

A 57-year-old man with extensive onychomycosis (fungal toenail infection) asks you for an evaluation. He requests a prescription for itraconazole for treatment of this problem after seeing a television advertisement for this drug. He has chronic heartburn attributed to gastroesophageal reflux disease and is treated with the proton pump inhibitor omeprazole. He is taking lovastatin for treatment of... 

Proton pump inhibitors (PPIs), eg, omeprazole, lansoprazole Irreversible blockade of H +, K+-ATPase pump in active parietal cells of stomach Long-lasting reduction of stimulated and nocturnal acid secretion Peptic ulcer, gastroesophageal reflux disease, erosive gastritis Half-lives much shorter than duration of action low toxicity reduction of stomach acid may reduce absorption of some drugs and increase that of others... 

In current clinical practice, many patients with symptomatic gastroesophageal reflux are treated empirically with medications without prior endoscopy, ie, without knowledge of whether the patient has erosive or nonerosive reflux disease. Empiric treatment with proton pump inhibitors provides sustained symptomatic relief in 70-80% of patients, compared with 50-60% with H2 antagonists. Due to recent cost reductions, proton pump inhibitors are increasingly being used as first-line... 

AstraZeneca (formerly Astra) has launched the proton-pump inhibitor esomeprazole (19) (as Nexium) as a treatment for peptic ulcer, gastroesophageal reflux disease, duodenal ulcer, and esophagitis. Esomeprazole is the (S)-enantiomer of omeprazole and was developed as a result of its improved pharmokinetic profile and better potency after oral dosing than (f )-form of omeprazole or the racemate. The dosage is higher than would be expected for a simple chiral switch. The stereogenic center is at sulfur. Detailed accounts of the development of the process have been published.189190... 

Indications Gastroesophageal Reflux Disease (GERD) Category Proton pump inhibitor Half-life 1.5 hours... 

Patients with gastroesophageal reflux disease receiving long-term proton pump inhibitor therapy... 

Acid peptic disease (overall less effective than proton pump inhibitors), gastroesophageal reflux dystrophy (GERD), Zollinger-Ellison syndrome. 

Proton-Pump Inhibitors for Gastroesophageal Reflux Disease... 

Proton Pump Inhibitors, Gastroesophageal Reflux Disease, and Asthma... 

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