Esomeprazole medical knowledge

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Esomeprazole medical knowledge

  1. 1. Esomeprazole®The most advanced PPI for acid regulation IDA
  2. 2. Agenda  Main GIT disorders  Disorders causes and symptoms.  Treatment pathways (probe for attendees)  Why PPI  Why Esomeprazole (vs. others PPI)  Indication , side effects and DDI  Dosage and price
  3. 3. Main GIT disorders
  4. 4. • Dyspepsia• Gastroesophageal reflux disease (GERD)• Peptic ulcer disease (PUD)• gastritis
  5. 5. Causes and Symptoms
  6. 6. Dyspepsia GERD Peptic Ulcer Gastritis• Abnormal function • Defect in • Inflammation (dysfunction) of the gastrin of lining of muscles of the production the stomach organs of the regulation -> • Caused by: gastrointestinal induction of Alchol tract acid Sever• May be functional production infection or organic from parietal NSAIDS (ulcerative) cells -> erosion of mucosa -> ulcer. • Caused by : H.Pylori NSAIDS
  7. 7. Dyspepsia GERD Peptic Ulcer Gastritis• heart burn • Heartburn • Abdominal • Burbing • Regurgitation pain• Early satiety • Dysphagia increased • Bloating • Odynophagia by food• Flatulence • Increased • Loss of • Unexplained salivation appetite weight loss• Fullness • Nausea • Heart burn • Chest pain • N&V • Yellow ,• N&V • Asthma false green or symptoms • May lead to bloody• Epigastirc pain perforation vomiting
  8. 8. How you deal with that ?
  9. 9. Life style Neutralizing Blocking acid Prokinetics acids production• Smoking • Antacids • H2 blockers • Promote downward• Weight (very temporary emptying of the loss treatment) • PPI esophagus and stomach.• Eating habits• Alcohol• Posture after meals
  10. 10. Why PPI ?
  11. 11. Recent PPI’s:LansoprazolePantoprazoleRabeprazoleOmeprazoleEsomeprazole
  12. 12. Why Esomeprazole?
  13. 13. Esomeprazole vs. Omeprazole esomeprazole is the s-enantiomar of omeprazole (racemic mixture) less first pass metabolism -> higher bioavailability -> more effective and longer lasting acid blockage -> 24 h interval Esomeprazole has increased antimicrobial activity against Helicobacter pylori than omeprazole. most of the esomeprazole metabolized by slower acting 3a4 enz, and the remaining metabolized by fast acting 2c19 , also it binds irreversibly to proton pump inhibiting acid secretion Journal of Clinical Gastroenterology: July 2004 - Volume 38 - Issue 6 - pp 503-506
  14. 14. Comparative Symptoms Relief clinical trial :
  15. 15. Indication• Treatment GERD• Dyspepsia• H.Pylori (in combination with clarithromycin or amoxicillin)• Healing and maintenance of Erosive esophagitis• Peptic ulcer especially NSAIDS-associated• Pathological hyper secretory condition e.g. : Zollinger-Ellison
  16. 16. Side effects  diarrhea,  Nausea & vomiting  headaches  rash and dizziness  Nervousness  abnormal heartbeat  muscle pain, weakness and leg cramps  water retention :infrequently.
  17. 17. Drug – drug interaction: Increase blood concentration of:  Diazepam : decrease its hepatic elimination  Digoxin : increase its gastric absorption Decrease concentration of:  Ketoconazole : decrease its gastric absorption
  18. 18. Dosage:  For GERD: 20 or 40 mg of esomeprazole once daily for 4-8 weeks  For H. pylori: 40 mg once daily + amoxicillin and clarithromycin for 10 days.  The dose for preventing NSAID-induced ulcers : 20 to 40 mg daily for 6 months.  Zollinger-Ellison syndrome: 40 mg twice daily.
  19. 19. Esomeprazole 14 tablet 70 L.E
  20. 20. THANK YOU !

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