Peptic disorders

Isenberg JI. (1991) Acid-peptic disorders. Textbook of Gastroenterology, Yamada T, Alpers DH, Owyang C, eds., (JB Fippincott Co, Philadelphia), pp. 1231-1349. 

Omeprazole is an antiulcer drug. It is a proton pump inhibitor. This substituted benzimidazole inhibits gastric acid secretion to help acid/peptic disorders and duodenal ulcers. It interferes with the proton pump in the mucous lining of the stomach, the last stage of acid production. It can turn off stomach acid in as little as one hour. Lansoprazole (no. 12) has a similar structure. 

Antacids have been used for centuries in the treatment of patients with dyspepsia and acid-peptic disorders. They were the mainstay of treatment for acid-peptic disorders until the advent of H2-receptor antagonists and proton pump inhibitors. They continue to be used commonly by patients as nonprescription remedies for the treatment of intermittent heartburn and dyspepsia. 

Since their introduction in the late 1980s, these efficacious acid inhibitory agents have assumed the major role for the treatment of acid-peptic disorders. Proton pump inhibitors (PPIs) are now among the most widely prescribed drugs worldwide due to their outstanding efficacy and safety. 

However, although calcium salts can produce short-term rehef from dyspepsia, calcium ions stimulate antral gastrin release, and hence gastric acid secretion, making them unsuitable for long-term treatment of peptic disorders (1). 

Kale-Pradhan PB, Landry HK, Sypula WT, Mena R, Perreault MM. Esomeprazole for acid peptic disorders. Ann Pharmacother 2002 36(4) 655-63. 

Reversible peripheral edema has been reported in five women taking the proton pump inhibitors omeprazole, lansoprazole, or pantoprazole for 7-15 days for peptic disorders in recommended standard doses (29). Edema disappeared within 2-3 days of withdrawal and reappeared in all five patients after re-exposure. High-dose intravenous infusions of omeprazole and pantoprazole (8 mg/hour) caused peripheral edema in three of six young female volunteers and two of six female volunteers respectively. The edema disappeared within 24 hours of stopping the infusion. Similar high doses of omeprazole did not produce edema in male volunteers. Subsequent studies performed on 10 female volunteers to elucidate the cause of the edema did not show any changes in concentrations of serum hormones or Cl esterase inhibitor. 

Cimetidine therapy led to a revolution in the treatment of acid-peptic disorders, with oral therapy being able to reduce the necessity of surgical procedures. The discovery of this landmark molecule caused a number of pharmaceutical companies to be alerted to this therapeutic area and target the discovery of a "better" Hz-receptor antagonist. Ranitidine was introduced by Glaxo in 1981 as a more... 

Del Valle J, Chey WD, Scheiman JM, et al. Acid peptic disorders. In Yamada T, Aplers DH, Kaplowitz N, et al, eds. Textbook of Gastroenterology, 4th ed. Philadelphia, Lippincott Williams Wilkins, 2003 1321-1376. 

GI TRACT Despite anecdotal reports that benzodiazepines improve a variety of anxiety-related G1 disorders, there is a paucity of evidence. Diazepam markedly decreases nocturnal gastric acid secretion in human beings, but other agents are considerably more effective in acid-peptic disorders see Chapter 36). 

SPECIEIC ACID-PEPTIC DISORDERS AND THERAPEUTIC STRATEGIES... 

Blum RA (1996) Lansoprazole and omeprazole in the treatment of acid peptic disorders. Am JHealth-Syst Pharm 53 1401-1415... 

Segal R, Russel WL, Ben-Joseph R, Mansheim B (1996) Cost of acid peptic disorders in a managed-care organization. Clin Ther 18(2) 319-333... 

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