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proton pump inhibitors PPT proton pump inhibitors PPT Presentation Transcript

  • SEMINAR ON PROTON PUMP INHIBITORS. SUBMITTED BY AVS.PRAVEEN KUMAR 07P25R0005. UNDER THEGUIDENCE OF Mr. K.SURENDRA Assistant professor,M.Pharm, RAO’S COLLEGE OF PHARMACY
  • PEPTIC ULCER .
    • INTRODUCTION:
    • DEFINITION:
    • Formation of sores or erosions in the lining of stomach and duodenum are referred as peptic ulcers.
    • Ulcers are known to be caused whenever
    • there occurs an imbalance b/n the protective
    • factors.
    • Use of non steroidal anti - inflammatory drugs
    • (NSAIDS).
    • Pathologic hypersecretory disorders.
    • Esophageal ulcers.
    • Gastric Ulcers.
    • Duodenal Ulcers.
    • Stress-induced Ulcers.
    • Marginal or anastomotic
    • Ulcers.
    • Drug or NSAID-induced
    • Ulcers.  
    • The common signs & symptoms of peptic ulcer
      • Pain after 2-3 hours of food consumption.
      • Heart burn and indigestion.
      • Belching (expulsion of gas).
      • Nausea, vomiting, loss of appetite and weight
      • loss.
      • Black tarry stools.
      • Pain in the abdomen with the burning
      • sensation.
      • Blood vomiting and pain during night time.
  •  
    • DIAGNOSIS
      • Endoscopy.
      • X-rays of Upper GI tract.
      • Gastric secretory studies show
        • hyperchlorhydria.
    • Hemorrhage or bleeding.
    • Penetration or spreading.
    • Gastric perforation.
    • Gastric outlet obstruction & Shock.
    • COMPLICATIONS
  •   ANTI ULCER DRUGS
    • DEFINITION
    • Anti ulcer drugs are medicines used to treat ulcers in
    • the stomach and the upper part of small intestine.
    • Anti secretory agents are the drugs that are used to
    • suppress or reduce the gastric acid secretion.
    • 1.Reduction Of gastric acid:
    • H2 Anti Histamines
    • Cimetidine
    • Ranitidine
    • Pantaprazole
    • b) Proton Pump Inhibitors.
    • Omeprazole
    • Lansoprazole
    • Pantoprazole
    • Rabeprazole
    • c) Anti cholinergics
    • Pirenzapine
    • Propantheline
    • Oxyphenonium
    • d) Prostaglandin Analogues
    • Misoprostil
    • Enprostil
    • 2) Neutralization of
    • gastric acid
    • a) Systemic
    • Sodium bicarbonate
    • (NaHCO 3 )
    • b) Non-Systemic
    • Magnesium hydroxide
    • Magnesium trisilicate
    • Aluminum hydroxide gel
    • Magaldrate calcium
    • 3) Ulcer protective
    • Sucralfate
    • Colloidal bismuth
    • sub citrate
    • 4)Ulcer Healing
    • Carbenoxolone
    • sodium
    • 5)Anti-H.pylori drugs
    • Amoxicillin
    • Clarithromycin
    • Metronidazole
    • Tinidazole
    • Tetracycline
  • PROTON PUMP INHIBITORS DRUG OF CHOICE
    • OMEPRAZOLE
    • ESOMEPRAZOLE
    • LANSOPRAZOLE
    • PANTOPRAZOLE
    • RABEPRAZOLE
  • Omeprazole. The proton pump inhibitor OMEPRAZOLE
  • OMEPRAZOLE . Systematic ( IUPAC ) name 6-methoxy-2-((4-methoxy-3,5-dimethylpyridin-2-yl) methylsulfinyl)-1 H -benzo[ d ]imidazole Chemical data Formula C 17 H 19 N 3 O 3 S   Mol. mass 345.4 g/mol Pharmacokinetic data Bioavailability 35–60% Metabolism Hepatic ( CYP2C19 , CYP3A4 ) Half life 1 - 1.2 hours Excretion 80% Renal 20% Faecal Therapeutic considerations Routes Oral, IV
  • PHARMACO K INETICS
    • ABSORPTION  
    • The absorption of omeprazole takes place in the
    • small intestine and is usually completed within 3–6
    • hours.
    • The systemic bioavailability of omeprazole after
    • repeated dose is about 60%.Plasma protein binding is
    • about 95%.
    • DISTRIBUTION
    • Distribution of the drug is wide and about 95% of the
    • drug is bound to proteins.
  • METABOLISM
    • Omeprazole. Sulphenic acid.
    • Enzyme inhibitor complex. Sulphenamide.
    • Omeprazole under goes rapid first pass
    • metabolism & systemic hepatic metabolism by
    • cytochrome P450,(CYP2C19 and CYP3A4).
    • The plasma half life of the drug is 0.5 to 1 hour
    • EXCRETION:
    • Urine : 80%
    • Faeces : 20%
  • PHYSIOLOGY OF HCL SECRETION
  • MECHANISM OF ACTION OF OMEPRAZOLE
    • Omeprazole belongs to the category of anti secretory
    • compound that act primarily by suppressing the gastric
    • acid secretion. This action is achieved by inhibiting the
    • H + /K + ATPase enzyme system selectively at the
    • secretory surface of the gastric parietal cells.
    • Adverse reactions
    • CNS Manifestations
    • CVS Manifestations
    • Endocrinal Manifestations
    • Gastrointestinal Manifestations
    •   Drug interactions
    • Omeprazole decreases plasma concentrations of Atazanavir.
    • Omeprazole increases plasma concentrations of
    • Crabamazepine, Tacrolimus, Diazepam.
    • Omeprazole effects are reduced incase of Amino glutethimide.
    • CONTRA INDICATIONS
  • Omeprazole 20 mg, Capsules Omeprazole 10 mg, Capsules OMEZ :10, 20, 40,mg capsules. PROTOLOC :20, 40,mg capsules.
    • MARKETED PRODUCTS
  • OTHER DRUGS
    • PANTOPRAZOLE
    • LANSOPRAZOLE
    • ESOMEPRAZOLE
    • RABEPRAZOLE
    • CONCLUSION
    • Proton pump inhibitors are the first class drugs in
    • the treatment of peptic ulcer and other gastro intestinal
    • disorders.
    • Mainly the drug omeprazole have less side effects when
    • compared to other drugs in this class. So this drug is used
    • very commonly in treating gastric disorders.
    • PPI use is not driven by secondary care admission.
    • Most patients prescribed a therapeutic rather
    • than maintenance dose.
  • REFFERENCE Essentials of medical pharmacology, by KD. Thripathi. Pharmacology & pharmaco therapeutics, by R.S. satoshkar. Text book of medical pharmacology, by Padmaja uday kumar. Pharmacology & clinical pharmaco kinetics, by G. Kutzung. Www. Proton pump inhibitor wikipedia, the free encyclopedia.
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