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Proton Pump Inhibitors To Protect The Stomach

1113 words - 4 pages

Proton pump inhibitors (PPI) are the drugs that reduce the secretion of gastric (stomach) acid. These drugs were introduced in the United States in the late 1980s. They have emerged as the standard of treatment for most acid-related disorders which causes dyspepsia. These disorders include gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger-Ellison syndrome, which is marked by excessive amounts of gastric acid. “Proton pump inhibitors are also successfully used for the treatment of Helicobacter pylori infection and upper gastrointestinal bleeding” (Der, 2003, p. 182). They may also be used to protect the stomach against “the ulcerogenic effects” of non-steroidal anti-inflammatory drugs or corticosteroid drugs (Fallon, 2009, p. 1347). According to El-Serag and Talley, “dyspeptic symptoms affect up to 25% of the population of the US and non-ulcer dyspepsia (including gastritis) contributes to the diagnosis in about 50% of patients referred for upper endoscopy” (2004). PPIs are prescribed for long-term therapy of upper gastrointestinal conditions since 15 years. However, it is also observed that there is significant increase in the inappropriate use of these drugs.
There are five drugs in the class of proton pump indicators (PPIs). They are Esomeprazole (Nexium), Lansoprazole (Prevacid), Omeprazole (Prilosec), Pantoprazole (Protonix), and Rabeprazole (Aciphex). These drugs act by binding with the enzyme H+, K(+)-ATPase i.e. hydrogen/potassium adenosine triphosphate (Fallon, 2009, p. 1347). The function of proton pump inhibitors is similar to the histamine H-2 receptor blockers. “H-2 receptor blockers interfere with the action of histamine that signal stomach cells to produce acid. Proton pump inhibitors are more effective because they destroy the enzyme that is responsible for making stomach acid at the first place” (“Heartburn,” 2010). In addition, these drugs are formulated in either an enteric coating or delayed-release capsules and are absorbed in the intestine after leaving the stomach (Uretsky, Samuel, & James W, 2011). According to Fallon (2009), proton pump inhibitors are eliminated from the body usually within 90 minutes of absorption and reduce acid production for 24 hours. “This is because the factor that determines duration of action is how long it takes the body to replace the H+, K(+)-ATPase. For example, a single dose of lansoprazole reduces stomach acid by 71%, but after a week of regular dosing, the acid reduction rises to 80%” (p. 1347).
Doses of these drugs vary, depending on the gastric conditions being treated. Commonly prescribed doses include – Esomeprazole: 20 to 40 mg once a day, Lansoprazole: 15 to 30 mg once a day, Omeprazole: 20 to 40 mg once a day, Pantoprazole: 40 mg once or twice a day, and Rabeprazole: 20 mg once a day. Lower doses of PPIs are usually adequate for GERD whereas higher doses for longer durations of time are sometimes required for treating chronic peptic ulcers (Uretsky,...

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