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Uploaded byMd. Hayder
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Proton pump inhibitors

The document discusses proton pump inhibitors (PPIs), which are drugs that reduce gastric acid production by inhibiting proton pumps in the stomach. It outlines the five main PPI agents, how PPIs work by irreversibly binding to and inactivating the proton pump, and their indications and uses for conditions like peptic ulcers and gastroesophageal reflux disease. Triple therapy combining a PPI with antibiotics is also described as a treatment approach for Helicobacter pylori-associated peptic ulcers.

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Welcome Md. Ali Hayder ID# 2015000300110 Batch: 25th Sec: D Southeast University (BD)
Assignment On: Proton pump Inhibitor
Proton pump O Integral membrane protein O “Pumps” proton into the stomach O By using ATP, an acidic hydrogen ion replace a non acidic potassium ion. (Ref: Katzung-12th/1084)
Proton pump Inhibitor O Proton-pump inhibitors are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production. O Inhibit the activity of proton pumps (Ref: Robbins and Cotran -8th)
PPIs agent O Five proton pump inhibitor are available for clinical use: 1. Omeprazole 2. Esomeprazole 3. Pantoprazole 4. Lansoprazole 5. Rabeprazole (Ref: Katzung-12th/1085)
Mechanism of action of PPIs O PPIs are administered as inactive prodrugs. O Converted into active form thiophilic sulfonamide cation in the parietal cell. O The sulfonamide reacts with the H+/K+ ATPase (proton pump), form a covalent disulfide linkage. O Irreversible inactivation of proton pump O Counter-transport of H+/K+ ions via proton pump is blocked O No secretion of H+ by Parietal cell. (Ref: Katzung-12th/1086-1087)
Mechanism of action of PPIs
Indication of PPIs O Peptic ulcer disease (PUD) H. pylori associated PUD. NSAID associated PUD. Perforation of bleeding PUD. O Gastro-esophageal reflux disease O Non ulcer dyspesia O Stress-related mucosal bleeding O Stress ulcer (Ref: Katzung-12th/1087-1088)
Triple therapy O Based upon a proton Pump inhibitor O This is act against H. pylori associated PUD O One proton pump inhibitor used with two antibiotics (from amoxicillin, clarithromycin and metronidazole) for 7 days. O After completion of triple therapy, PPI should be continued once daily for a total of 4-6 weeks. (Ref: Davidson’s-medicine-20th/887,888)
Adverse effects of PPIs O General: PPIs are safe drug but 1-5% cases the following adverse effect are reported- Diarrhea Headache Abdominal pain Safety during pregnancy is not established O Subnormal Vitamin B12 level ( prolonged use) O Respiratory & enteric infection (Ref: Katzung-12th/1088-1089)
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