The pharmacology and clinical relevance of proton pump inhibitors.
Gastroesophageal reflux disease is a complex, multifaceted disorder affecting a large proportion of the US population. Its management is based on the principle of optimal antisecretory therapy, mainly with proton pump inhibitors (PPIs). The optimal treatment outcome is complete symptom relief, which can be achieved with optimal use of PPIs. PPI treatment requires an understanding of the pharmacology of these agents as well as their clinical efficacy, strengths, and weaknesses. This paper reviews the pharmacology of PPIs, the principles of optimal dosing, nocturnal gastric acid breakthrough and its clinical importance, and a treatment approach to gastroesophageal reflux disease using these agents.
Katz
Philip O
PO
Department of Gastroenterology, Graduate Hospital, Suite 501, Pepper Pavilion, 1800 Lombard Street, Philadelphia, PA 19146, USA.
Frissora
Christine
C
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles / Q000494:pharmacology / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D005744:Gastric Acid / Q000378:metabolism; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D064747:Lansoprazole; D009853:Omeprazole / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors; D064750:Rabeprazole; D013454:Sulfoxides / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D013454:Sulfoxides; D064747:Lansoprazole; D064750:Rabeprazole; D000077402:Pantoprazole; D009853:Omeprazole