Proton pump inhibitors
Proton pump inhibitors disrupt chemical binding in stomachcells to
reduce acid production, lessening irritation and allowing peptic ulcers to
better heal. They include:
Proton pump inhibitors are given orally in
enteric-coated formulas to bypass the stomach because they’re highly unstable
in acid. When in the small intestine, they dissolve and are absorbed rapidly.
These medications are highly protein-bound and are
extensively metabolized by the liver to inactive compounds and then eliminat-ed
Proton pump inhibitors block the last step in the
secretion of gas-tric acid by combining with hydrogen, potassium, and adenosine
triphosphate in the parietal cells of the stomach.
Proton pump inhibitors are indicated for:
· short-term treatment of active gastric ulcers
active duodenal ulcers
symptomatic GERD unresponsive to other therapies
active peptic ulcers associated with H.
pylori infection, in com-bination with antibiotics
long-term treatment of hypersecretory states such as Zollinger-Ellison
Proton pump inhibitors may interfere with the
metabolism of di-azepam, phenytoin, and warfarin, causing increased half-life
and elevated plasma levels of these drugs.
Proton pump inhibitors may also interfere with the
absorption of drugs that depend on gastric pH for absorption, such as
ketocona-zole, digoxin, ampicillin, and iron salts. (See Adverse reactions toproton pump inhibitors.)