Gastrointestinal drugs proton pump inhibitors

DRUGS ACTING ON THE GASTROINTESTINAL TRACT PROTON PUMP INHIBITORS... 

FIGURE 55-2. Treatment of osteoarthritis. OA, osteoarthritis COX-2, cyclooxygenase-2 CV, cardiovascular Gl, gastrointestinal, IA, intraarticular NSAID, nonsteroidal anti-inflammatory drug PPI, proton pump inhibitor. 

Pantoprazole sodium, a substituted benzimidazole derivative, is an irreversible proton pump inhibitor, and was developed for the treatment of acid-related gastrointestinal disorders. As with other drugs of its class (e. g. omeprazol or lansoprazole), pantoprazole reduces gastric acid secretion through inhibition of the portion on the gastric parietal cell. In combination with other drugs, pantoprazole can be used for the initial treatment of H. Pylori infection [1],... 

Bardhan KD. Pantoprazoie a new proton pump inhibitor in the management of upper gastrointestinal disease. Drugs Today, 1999, 35(10), 773-808. 

Gastrointestinal. Patients taking continuous steroid, especially in combination with a nonsteroidal antiinflammatory drug (NSAID), have an excess incidence of peptic ulcer and haemorrhage of about 1-2%. It is plainly unreasonable to seek to protect all such patients by routine prophylactic antiulcer therapy, i.e. to treat 98 patients unnecessarily in order to help two. But such therapy (proton pump inhibitor, histamine H -receptor blocker, sucralfate) is appropriate when ulcer is particularly likely, e.g. a patient with rheumatoid arthritis taking an NSAID, or for patients with a history of peptic ulcer disease. There is increased incidence of pancreatitis. 

Richardson P, Hawkey CJ, Stack WA. Proton pump inhibitors. Pharmacology and rationale for use in gastrointestinal disorders. Drugs 1998 56 307-335. 

For drugs administered oraUy, impaired gastrointestinal (GI) absorption is an important consideration. For example, aluminum ions in certain antacids or ferrous ions in oral iron supplements form insoluble chelates of tetracycline antibiotics, thereby preventing their absorption. The antifungal ketoconazole is a weak base that is only soluble at acid pH. Drugs that inhibit gastric acidity, such as the proton pump inhibitors and histamine Hj receptor antagonists, impair the dissolution and absorption of ketoconazole. 

The dru presented in this ch )ter include the antacids, anticholinergics, GI stimulants, proton pump inhibitors, histamine H2 antagonists, antidiarrheals, antiflatulents, digestive enzymes, emetics, gallstone-solubilizing dru, laxatives, and miscellaneous dru. Some of the more common preparations are listed in the Summaiy Drug Table Dni Used in tlie Man ement of Gastrointestinal Disorders. 

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