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 in urine.
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
· erosive esophagitis
· 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 syndrome.
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.)