Proton pump inhibitors

It is helpful to study PPIs.

1. Welcome Md. Ali Hayder ID# 2015000300110 Batch: 25 th Sec: D Southeast University (BD)

2. Assignment On: Proton pump Inhibitor

3. Proton pump Integral membrane protein “Pumps” proton into the stomach By using ATP, an acidic h ydrogen ion replace a non acidic potassium ion . ( Ref: Katzung-12 th /1084)

4. Proton pump Inhibitor Proton-pump inhibitors are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production . I nhibit the activity of proton pumps ( Ref: Robbins and Cotran -8 th )

5. PPIs agent Five proton pump inhibitor are available for clinical use: 1. Omeprazole 2. Esomeprazole 3. Pantoprazole 4. Lansoprazole 5. Rabeprazole ( Ref: Katzung-12 th /1085)

6. Mechanism of action of PPIs PPIs are administered as inactive prodrugs . Converted into active form thiophilic sulfonamide cation in the parietal cell. The sulfonamide reacts with the H +/K+ ATPase (proton pump), form a covalent disulfide linkage. Irreversible inactivation of p roton pump Counter-transport of H+/K+ ions via proton pump is blocked No secretion of H+ by Parietal cell. ( Ref: Katzung-12 th /1086-1087)

7. Mechanism of action of PPIs

8. Indication of PPIs Peptic ulcer disease (PUD) H. pylori associated PUD. NSAID associated PUD. Perforation of bleeding PUD. Gastro-esophageal reflux disease Non ulcer dyspesia Stress-related mucosal bleeding Stress ulcer ( Ref: Katzung-12 th /1087-1088)

9. Triple therapy Based upon a proton Pump inhibitor This is act against H. pylori associated PUD One proton pump inhibitor used with two antibiotics (from amoxicillin, clarithromycin and metronidazole) for 7 days. After completion of triple therapy, PPI should be continued once daily for a total of 4-6 weeks. ( Ref: Davidson’s-medicine-20 th /887,888)

10. Adverse effects of PPIs 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 Subnormal Vitamin B12 level ( prolonged use) Respiratory & enteric infection (Ref: Katzung-12 th /1088-1089)

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