Proton pump inhibitory therapy: then and now.
Proton pump inhibitors (PPIs) have been established as the new "gold standard" for traditional acid-inhibitory treatment of the so called "peptic" diseases. Due to the high antisecretory and ulcer-healing potency of omeprazole, no major improvements of the efficacy in ulcer healing and pain relief can be expected. Pantoprazole, as a further development in PPIs, is characterized by improved pharmacokinetic behavior as well as by higher tissue selectivity and binding specificity and by a very low potential to interact with the cytochrome P450 enzyme system. These characteristics may provide the basis for a low potential for side effects and for a more favorable interaction profile, although the clinical relevance of these potential advantages remains to be proven. Reflux esophagitis will also remain a domain for the traditional use of PPIs in the future. However, in the treatment of gastroduodenal ulcers, the acid inhibitory potential of PPIs will be used mainly to facilitate the eradication of H. pylori.
Schepp
W
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Second Department of Internal Medicine, Technical University of Munich, Germany.
D000900:Anti-Bacterial Agents / Q000032:analysis / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004355:Drug Stability; D004381:Duodenal Ulcer / Q000188:drug therapy; D004791:Enzyme Inhibitors / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004941:Esophagitis / Q000188:drug therapy; D005753:Gastric Mucosa / Q000737:chemistry / Q000187:drug effects* / Q000382:microbiology; D015408:Gastrinoma / Q000188:drug therapy; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000378:metabolism; D013276:Stomach Ulcer / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D017494:Proton Pumps