How long can you take proton pump inhibitors. Proton pump inhibitors: generation classification. Possible side manifestations

Proton pump inhibitors (IPP) on the modern pharmaceutical market are isolated in the form of capsules or tablets. These drugs can be used only by appointing the attending physician. More information about medication. You will learn from our article.

The pathology of the stomach mucosa, which arose due to disorders of the acidity of the gastric juice, is treated with proton pump inhibitors. Preparations of this group are prescribed under various diseases of the stomach (ulcers, gastritis, gastroduodenitis, reflux-esophagitis, esophagus erosion, etc.), their action is aimed at reducing the production of gastric juice.

In addition, proton pump inhibitors are necessarily used in complex therapy with antibacterial drugs for the eradication of Helicobacter Pylori bacterium, as well as in the case of a systematic reception of drugs that negatively affect the operation of the stomach and intestines.

How preparations work

The drug preparation is used inward, drinking enough water. The active ingredient of the drug enters the intestines, after which absorption in the blood. Next, the active substance of the drug penetrates into the mucous membrane of the stomach.

It should be noted that in the first days after the start of receiving the proton pump inhibitors, the patient does not notice any changes in the positive side. First of all, this is due to the fact that the data of the pills have a cumulative effect, that is, they begin to work in full force after a sufficient amount of active substance is accumulated in the secretion of the gastric juice.

These drugs are used in complex treatment with probiotics, enzyme and antacid drugs, sometimes with antibiotics.

Basically, proton pump inhibitors are aimed at reducing hydrochloric acid, which is necessary in the treatment of ulcers. The fact is that with the increased acidity of the gastric juice of the ulcer of the stomach or duodenum progresses. The decrease in acidity is necessary in order to speed up the healing process in the stomach. In addition, these funds are prescribed with chronic gastrointestinal diseases as prevention of exacerbations twice a year.

Indications for use

The gastroenterologist prescribes proton inhibitors in the event that the pathology of the stomach is caused by a change in the level of acidity of the gastric juice. This feature is usually found in the following diseases of the gastrointestinal tract:

• chronic heartburn;
• gastritis of various etiology;
• gastroduodenitis;
• the presence of stomach ulcers or duodenum.

Despite the fact that proton pump inhibitors very rarely cause side effects, have a minimum list of contraindications, - this drug is recommended only to appoint a doctor.

If your diagnosis is not confirmed by a specialist, this kind of self-treatment can lead to irreversible consequences.

Contraindications for reception

Proton pump inhibitors have a standard list of contraindications:

• In the official annotation to the IPP, it is said that the reception of funds is categorically not recommended to women carrying a child, as well as in breastfeeding.
• It is impossible to treat the stomach with the help of these drugs to children who have not reached 12 years.
• Also in the list of contraindications there is a string, which refers to the individual intolerance of the active substance. In this case, the doctor changes the pills to similar.

Despite the manufacturer's recommendations, in some cases the doctor may assign a reception of tablets during pregnancy and feeding. This usually happens in extreme cases when there is no other output for a woman "in the position".

Possible side effects

For each group of blockers, individual side effects are characterized. It should be noted that they are quite rarely found. Consider the main of them:

• nausea;
• loss of appetite;
• headache;
• constipation or diarrhea;
• vomiting;
• pain in the stomach;
• allergic reaction in the form of a rash on the skin.

Effective IPP

Proton pump inhibitors can be divided into five groups. Their differences is the active ingredient and its number. Depending on the active component, the reception scheme, treatment or drug dosage rate may vary. All existing types of inhibitors are aimed at reducing the production of gastric juice. Consider a list of the most efficient drugs.

The active ingredient and its dosage appoints the attending physician depending on the type of disease, the degree of its gravity, symptoms and contraindications in the patient.

Lansoprazole-based preparations

The difference of this group is high suction. These funds include: Lanzoz, Helick, Lansoprol, Lanzoptol, Lanpro, Lancet, Lancer and others.

Let us dwell in more detail on the most popular Lansoprazole based medicines:

• Acrylase. The drug is produced in the form of capsules. The packaging contains 30 mg of the active substance. One blister has 10 tablets. The manufacturer releases a drug in 10, 20 or 30 capsules. According to the official annotation, the medication is recommended to drink once a day. Depending on the severity of the disease, the reception scheme and course of treatment can be adjusted by the attending physician.
• Lancide. Means for the treatment of acid-dependent diseases of the gastrointestinal tract produced in capsules. The composition of one capsule contains 15 mg of the active component. The dosage of the drug is designed for one-time reception. With serious diseases, the doctor may increase the dosage.
• Epicurus. The composition of each capsule of this proton pump inhibitor contains 30 mg of the active ingredient. In one package there are 10 capsules. The method of reception and dose is no different from the above-mentioned tools.

Medicines based on omeprazole

To date, the most popular remedy that is prescribed with increased secretion of gastric juice, as well as in the presence of stomach ulcers. Many studies have proven the effectiveness of this medicine. Medicines with this existing substance have an advantage - low cost.

These tablets with an active substance "omeprazole" are distinguished: Gastozol, Demeprazole, Ultra, Ortanol, Helicide, etc.

Consider some names of these proton pump inhibitors:

• Omes. New generation capsules contain a slightly larger substance, compared with lansoprazole-based preparations. In one capsule - 40 mg of the active component. Apply one day. This dosage is enough to oppress the production of acid in the day and night. The course of treatment determines the attending physician.
• Bioprazole. In one capsule there are 20 mg of the active substance. The proton pump inhibitor effectively reduces the acidic products. On a day it is necessary to drink only one capsule.
• Omesol. The proton pump inhibitor contributes to the oppression of hydrochloric acid. The composition of one tablet contains 40 mg of the active component. Take one capsule per day. In some cases, the doctor recommends taking the drug twice.
• Losek. In one capsule - 30 mg of the active substance.

It should be noted that the inhibitors of the proton pump based on omeprazole are outdated and today it is rarely applied rather as therapy of diseases of the gastrointestinal tract.

Pantoprazole-based medicines

The proton group has some feature - they carefully affect the mucous membrane of the stomach. For this reason, the course of treatment can be long in order to avoid possible recurrences.

This group includes: Aspan, proxium, Sanpair, Panum, Puloref, Ulter, Pantaz, etc.

Let us dwell on some of Pantoprazole-based medicines:

• Controls. The inhibitor is produced in tablet form. In one capsule, 20 or 40 mg of the active ingredient may be contained. Depending on the diagnosis, the method of use and dose may differ.
• Nalpaza. Released in a dosage of 20 and 40 mg. The peculiarity of this drug is its reception is prohibited until 18 years of age. Use it once a day, preferable in the morning.
• Ulter. The proton pump inhibitor is an analogue of Nalpaz. Dosage and method of reception are identical.

After final recovery, medicines can be appointed as prevention.

Rabeprazole-based drugs

Funds of this group effectively cope with the task.

Among the medicines on the basis of Rabeprazole, they allocate: Salispan, Ottem, Pariet, etc.

We describe in detail the action of some drugs based on Rabeprazole:

• Beret. The proton pump inhibitor contains 20 or 40 mg of the active component. The medicine is prescribed once or twice a day, depending on the purpose of therapy.
• Zulbex. Produced in the form of tablets, in the composition there are 20 mg of the active substance. The drug is often prescribed to treat ulcers. For effective treatment of sufficiently single reception, the means is preferable in the morning.
• Rabel. It is often prescribed as the prevention of the development of the ulcer of the stomach or duodenum. There is only 15 mg of the active ingredient.

Most often, tablets or capsules based on Rabeprazole are prescribed in the presence of stomach ulcers.

Medicines based on Ezomeprazole

A feature of this group is that the active components of the funds for a long time remain in the human body. For this reason, doctors usually prescribe a minimum dosage once a day.

To the means of this group include: neo-zekst, Ezomeprazole Canon, etc.

The most popular Esomeprazole-based medicines are as follows:

• Nexium. The main indication for treatment is a gastroesophageal reflux disease. Available in a dosage of 20 mg. The disadvantage of this fund is a fairly high price. One package costs about 1,500 rubles.
• Emanner. Assign twice a day. Contains 20 mg of active substance. Based on user reviews, it can be concluded that the tool has good efficiency, but quite high cost.

Depending on the severity of the illness, the dosage may vary.

To date, doctors and patients prefer preparations based on Lansoprazole and Pantoprazole. This group very rarely causes side effects and is suitable for almost every person. In addition, the course of treatment with capsules based on these actors is much shorter. Remember that any proton pump inhibitor must be appointed only by the attending physician after the diagnostic survey.

Proton pump inhibitorsthey have the most powerful effect among all antisecretory drugs. The use of these drugs significantly improves the forecast for diseases due to excessive acid products in the stomach (ulcerative ulcer of the stomach and duodenum, gastroesophageal reflux disease, Zolinger-Ellison syndrome, NPID-gastropathy, functional dyspepsia). The first inhibitor of the proton pump was opened omeprazole (losek, gastrosis, omise, etc.), Lansoprazole (Lanzoptol Lanzoptol) were synthesized (Lanzoptol), Pantoprazole (controls) and Rabeprazole (Pariet). Recently, the optical S-isomer of omeprazole - Ezomeprazole (Nexium) was synthesized.

The main advantages of proton pump inhibitors, taking into account the treatment of patients: (1) relatively quickly comes the effect of eliminating heartburn and / or blatic pain and in the epigastric region, especially during the daytime, in patients with different acid-dependent diseases; (2) more intense inhibiting acid formation in the stomach for a longer time compared to H2 receptor antagonists and antacid drugs; (3) High efficiency of proton pump inhibitors in various schemes of antichelicobacter therapy; (4) Higher efficiency in the treatment of patients with hydrochloric acid hypersecretion.

General features of proton pump inhibitors: (1) Quite unstable to the effects of the acidic content of the stomach (except Ezomeprazole); (2) Quickly absorbed in the small intestine (including in the duodenum); (3) have a similar mechanism of action; (4) have sufficiently high similar activation levels at low pH; (5) due to the ability to increase the pH of the contents of the stomach, can change the absorption of some drugs (for example, increase the absorption of acid-resistant antibiotics); (6) They have a short half-life (within 1 hour in most people) and minor renal clearance.

Mechanism of action. The proton pump (or proton pump) inhibitors are substituted benzimidazole derivatives. Being in the chemical nature weak grounds, they accumulate in the channels of parietal cells, where they are converted to tetracyclic sulfenamide. Sulfenamide is covalently with the help of disulfide bonds binds to cysteine \u200b\u200bproton pump groups, which leads to the inhibition of the enzyme (H +, K +) - the atpasis located on the apical membrane of parietal cells of the stomach mucosa. The enzyme (H +, K +) - the atfase transfers the hydrogen ions from the parietal cell into the lumen of the stomach. Accordingly, the inhibition of this enzyme leads to the oppression of the secretion of acid. Suppression of acid production by these drugs does not depend on the state of the receptors (H2, M3, etc.) on the basal membrane of parietal cells. It should be noted that the high selectivity of the proton pump inhibitors is due to the fact that their activation is possible only with an acidic pH value (<4), в то же время они не устойчивы в кислой среде, поэтому при пероральном введении ингибиторы протонного насоса должны быть защищены от воздействия кислоты желудка. Данная проблема решается покрытием капсул, содержащих действующее вещество - ингибитор протоновой помпы, оболочкой, которая растворяющейся в щелочной среде. Минуя желудок, они быстро всасываются в кишечнике в щелочной среде и перераспределяются между органами и тканями.

Dosing mode. Inside: in the morning, before meals. Not chewing. Squeezing with a small amount of water. Intravenously: once a day. The use of proton pump inhibitors in elderly patients does not require a dose correction. Since proton pump inhibitors are characterized by a slow start of action (no earlier than 1 hour), they are not suitable for therapy on demand (at the moment of pain, heartburn).

Comparative characteristics of drugs. Omeprazole, Pantoprazole and Lanzoprazole differ in a chemical structure, bioavailability, half-life, etc., but the results of their clinical use are almost identical. The minimum inhibiting concentration for omeprazole is 25-50 mg / l, lanzoprazole - 0.78-6.25 mg / l, pantoprazole - 128 mg / l. Therapeutic modes with Lanzoprazole provide an earlier admission of clinical remission in comparison with omeprazole. The frequency of recurrence of peptic ulcers after treatment with Lanzoprazole is 55-62%, pantoprazole - 55%, omeprazole - 41%. Currently, only omeprazole and Lanzoprazole are allowed for long-term supporting therapy. Long-term use (more than 5.5 years) omeprazole in patients does not lead to the development of neoplastic changes. In patients with ulcerative disease that have supported Pantoprazole's supporting therapy in a dose of 40-80 mg daily for more than 3 years, a minor and statistically insignificant increase in the number of ECL cells was noted. Unlike omeprazole and Lanzoprazole, Pantoprazole interacts significantly less with the cytochrome r-450 system. The antacids, like food, does not affect the pharmacokinetics of pantoprazole. Sukralfat and food intake can change Lanzoprazole absorption. The pharmacokinetics of omeprazole can be changed by intake, but does not change with liquid antacids. Therefore, Lanzoprazole and omeprazole are taken 30 minutes before meals, and Pantoprazole - regardless of meals.

Medicinal interaction. Omeprazole and its stereoisomer Ezomeprazole can somewhat slow down the removal of drugs, metabolizing with the help of the cytochrome R450 system (diazepam, warfarin, phenytoin). The absorption of ketakonazole and itraconazole may decrease when a joint admission with the omeprozole and Ezomeprazole. The metabolism of caffeine, theophylline, propranolol, chinidine and other drugs is not disturbed. When using Rabelrazole, the absorption of ketoconazole may decrease and the absorption of digoxin increases. Lansoprazole increases theophylline clearance during oral administration.

Side effects. (1) Side effects observed with short course of therapy: most often occur by side effects from the central nervous system, such as headache, fatigue, dizziness, and from the gastrointestinal, such as diarrhea path or constipation. In rare cases, allergic reactions are noted (skin rash, phenomena of bronchospasm). With intravenous administration of omeprazole, the possibility of violations of violations and hearing is described. (2) Side effects observed with long-term reception of drugs of the omeprazole group, Lansoprazole and Pantoprazola: hyperplasia of enterochromaphrochetine cells of the gastric mucosa, the progression of atrophic gastritis phenomena (but the risk of malignelation does not increase); With prolonged use of large doses of proton pump inhibitors, a decrease in the absorption level of vitamin B12 is noted. One of the unpleasant side effects with a long-term intake of proton pump inhibitors is the appearance of a significant swelling of the abdomen and an involuntary disorder of gases through anus in unforeseen situations (in transport, at work during official meetings, etc.), which is essential worsens the quality of life of patients. Against the background of long-term intake of proton pump inhibitors in some patients of elderly and senile age, there is a significant deterioration in view. For proton pump inhibitors, as well as for H2 receptor antagonists, it is characterized by "cancellation syndrome", more pronounced in the abolition of Ezomeprazole, prescribed by patients in a dose of 40 mg.

(!) Based on the analysis of the long-term use of omeprazole, concluding that persons, long-continuously receiving proton pump inhibitors, do not have any additional risk of cancer in comparison with those who have not accepted these drugs.

(!) Against the background of long-term treatment with various original proton pump inhibitors, it is possible to appear the acquired (secondary) resistance to one or another proton pump inhibitors. Such resistance becomes noticeable after long-term treatment with the same drug when its effectiveness against the background of constant treatment of patients (for a year or more) is significantly reduced, but the "translation" of patients for treatment with other proton pump inhibitors improves their condition.

Doses and application of omeprazole(Omeprazole). Inside: for ulcerative gastric ulcer, duodenal and reflux-esophagite - 20 mg 1 time per day (if necessary - 40 mg). For a duodenal ulcer, a course of treatment for 2-4 weeks, with a stomach and reflux-esophagite ulcer - 4-8 weeks. For the prevention of peptic ulcer - 20 mg 1 time per day. With Zollinger-Ellison syndrome: the initial dose is 20-60 mg per day, if necessary, up to 120 mg / day (daily dose above 80 mg should be divided into two receptions) for 2-8 weeks. The level of secretion in the stomach should be in unsecured patients up to 10 mmol HCl / h, in respected - up to 5 mmol HCl / h. In combined eradication antihelicobacter therapy with peptic ulcers - omeprazole 20 mg for 7 days. Intravenously: 1 time per day. Substance (40 mg) is dissolved in 100 ml of a physiological solution or a 5% solution of dextrose and administered within 20-30 minutes after dilution. Infusion must be completed in 12 hours, if the solvent is saline, and for 6 hours, when dissolved in dextrose. It is usually sufficient to conduct infusions for 2-5 days, after which the patient can be translated into oral administration.

Doses and application of Lanzoprazole(Lansoprazole). Inside: Unex Dyspepsia: 15-30 mg per day for 2-4 weeks. Gastric ulcer: 30-60 mg per day for 4-8 weeks. Erosive-ulcerative esophagitis: 30-60 mg per day for 4-8 weeks. Reflux-Ezophagitis: 30 mg per day for 4 weeks. Zolinger-Ellison syndrome: the dose is individually selected, providing basal acid production below 10 mmol / h. In the combined eradication antihelicobacter therapy: 30 mg 2 times a day for 7 days.

Doses and application Pantoprazole (Panthoprazole). Inside: monotherapy of peptic ulcer of the stomach and duodenum, gastroesophageal reflux disease - usually 40 mg / day, possibly (increase in dose) to 80 mg / day (especially in erosive and ulcerative forms of reflux-esophagitis). The duration of the course for ulcerative duodenal disease - 14 days (sometimes up to 2 weeks), with ulcer of the stomach and gastroesophageal reflux disease - 4 weeks (in some cases for an even 4 weeks). In the combined eradication antihelicobacter therapy, Pantoprazole is used by 40 mg 2 times a day (before breakfast and before dinner or during meals, without chewing and not destroying the integrity of the tablet, floating fluid).

Doses and application of Rabbrazole(Rabeprazole): inside 20 mg 1 time per day; with ulcer of the stomach and duodenal sector in the aggravation stage - within 4-6 weeks, if necessary - up to 12 weeks; With reflux-esophagitis: 4-8 weeks, maintaining therapy is possible: 10-20 mg 1 time per day; In the syndrome of Zolinger-Ellison, the dose is selected individually. As part of the eradication antihelicobacter therapy, Rabeprazole is used using the appropriate combinations of antibiotics within 7 days.

Doses and application of Ezomeprazole(Esomeprazol). Inside. The tablet should swallow the entirely by drinking the liquid. Tablets can not be chewed or broke. Treatment of erosive reflux-esophagitis: 40 mg 1 time per day for 4 weeks. An additional 4-week course of treatment is recommended in cases where, after the first year, esophagitis is not coming or symptoms remain. Prevention of relapses in patients with cured esophagitis: 20 mg 1 time per day. Symptomatic treatment of GERB: 20 \u200b\u200bmg 1 time per day - patients without esophagitis. If after 4 weeks of treatment of symptoms do not disappear, additional examination of the patient should be carried out. In combination with the appropriate antibacterial therapy for Eradication of Helicobacter Pylori, treatment of a 12-rosewoman ulcers associated with Helicobacter Pylori, preventing peptic ulcers recurrence in patients with peptic disease associated with Helicobacter Pylori: Ezomeprazole is applied at a dose of 20 mg for 7 days. Patients with renal failure and for elderly patients do not need a dose correction. With severe liver failure, the dose should not exceed 20 mg / day.

For the treatment of various acid-dependent diseases of the gastrointestinal tract, at least 18 hours per day, maintain a permanent pH of the gastric juice. So, for successful getting rid of, it should be over 4, for healing - 3. With the eradication of N. pylori (bacteria that contribute to the development of gastritis, ulcerative disease and other stomach pathologies), it is necessary that the pH of the gastric juice is over 5. achieve long-term maintenance The necessary acidity is used by the proton pump inhibitors (IPP). They are most effective among all drugs that have an antisecretory action.

What drugs relate to IPP

The composition of the gastric juice includes hydrochloric acid. It is produced in the stomach itself. At the beginning, parietal cells secrete chlorine and potassium ions. Then, with the help of enzyme H + / K + -ATF-Ase, potassium ions are replaced with hydrogen protons. The complex process of transporting hydrogen and the creation of hydrochloric acid is called proton pump. In order for the mechanism of the secretion of the acid began, special antisecretory preparations are used.

The proton pump inhibitors (inhibitors H + / K + -ATF-AZA) create a covalent bond with an enzyme transporting hydrogen, as a result, the secretion of hydrochloric acid is blocked. Possess this action derivatives of benzimidazole:

• Omeprazole (omens, oprarajole, gastrosis, ultra);
• Pantoprazole (Zovanda, Pangastro, Panzol, Pantex);
• Lansoprazole (Lanzoz, Normicid, Lanzerol);
• Rabeprazole (Pariet, Barol, Role);
• Ezomeprazole (Ezomealkas, Nexium, Esezol);
• Declansoprazole (dexilant).

The very first IPP, which was used in clinical purposes, was omeprazole. It was synthesized in 1979 in Sweden. And in 1988, a new group of drugs - proton pump inhibitors - was recognized as the most effective for the treatment of acid-dependent states.

Other drugs inhibiting H + / K + -TF-AZA began to be created. In 1991, Lansoprazole was created in France, in 1994 Pantoprazole (Germany), in 1996 Rabeprazole (United Kingdom).

Now in clinical practice, the Isomer osomer omeprazole - Ezomeprazole is used in 2001 in Sweden. This drug is considered to be the most efficient, its bioavailability is higher, it reduces the secretion of hydrochloric acid for a longer time.

For which IPP is prescribed

IPPs are used to diagnose acid-losses. Apply an omeprazole test. The regression of the symptoms of the disease () is manifested by 3-5 days after receiving 40 mg of omeprazole. If this does not occur, the cause is other pathologies.

Features of the use of IPP

All IPPs - Prodrugs. They do not immediately. First, under the influence of acid, they pass into the active form - sulfenamide. And this substance blocks the enzyme involved in the synthesis of hydrochloric acid. To ensure that the medicine should be taken into account the features of the IPP:

1. So that the proton pump inhibitors are activated, the acidic medium is needed (the pH of the gastric juice should be no higher than 4). Therefore, they are useless to apply in a complex with other antisecretory drugs.
2. We need to take a medicine on an empty stomach, half an hour before breakfast. Drink it once a day. The drug for a long time inhibits hydrochloric acid production in the stomach.
3. All IPSs are weak alkalis. Under the influence of hydrochloric acid, the active form of benzimidazole turns into a sulfenamide, forming an irreversible connection with H + / K + -TF-Aza. So that the proton pump began to work again, it is necessary to update the molecule of this enzyme. It happens for 30-48 hours. Therefore, IPPs for a long time establish a certain pH of the gastric juice. The level of acidity depends on the dose of the drug.
4. IPPs affect the suction of some drugs. They accelerate the absorption of digoxin, antibiotics belonging to the group of macrolides; Slow suction of ampicillin, atazanavir, ketoconazole, iron preparations.
5. After the cancellation of the IPP, the secretion of hydrochloric acid is restored after 3-5 days.

All IPSs in a short time eliminate such an unpleasant symptom as heartburn. But it should not be at the emergence of this sign right away to the pharmacy and buy omeprazole or its modern counterparts. Be sure to complete the complete diagnosis and eliminate the presence. IPP mask the symptoms of this dangerous disease, it makes it difficult for early diagnosis. And the proton pump inhibitors have contraindications to use, and they can cause side effects.

Side effect IPP

Before you designate the IPP, the doctor determines the beneficiation ratio. These drugs are not recommended pregnant, nursing, children under 14 years old. They are categorically contraindicated in hypersensitivity to benzimidazole derivatives.

The reception of the IPP sometimes causes side effects:

• abdominal pain;
• dry mouth;
• rash, itching;
• headache, dizziness;
• drowsiness;
• pain in the joints, muscles;
• weakness.

Since the RFP reduces the absorption of iron salts, due to prolonged drugs can occur.

Most side effects are short-term and stop after the end of the therapeutic course. Sometimes with prolonged use of IPPs arises:

• nodule hyperplasia cell mucosa cells of the stomach;
• medicinal;
• progresses.

Therefore, before receiving drugs, the doctor's consultation is obligatory.

Output

IPP effectively and quickly eliminate heartburn, contribute to the rapid scarring of ulcers and even oppress the growth of bacteria causing gastritis. They have fewer side effects, and they act longer than other antisecretory drugs. But independently treated them should not.

When symptoms of acid-dependent states appear (sternum pain, heartburn, bleeding from the esophagus, stomach), it is necessary to undergo a diagnosis to identify the cause of these signs. And what kind of research is needed, the gastroenterologist will recommend. After the examination, the doctor will determine the feasibility of the admission of proton pump inhibitors.

More than 90% of the population suffers from problems with digestion, heartburn and gastrite, but few know that drugs designed to alleviate the state have long existed and are actively used in medical practice in cases where antacids do not help. We'll figure it out what is the proton pump inhibitor, the list of drugs will also consider.

Where did the person come from a person in the body?

The proton pump, it is the proton pump - it is an enzyme protein that promotes developing it is the necessary and most important effect for the process of digestion. However, it often happens that the acid begins to be produced in large quantities, which entails unpleasant and painful sensations in the stomach.

Indications for use

The proton pump inhibitor (the list of drugs will be listed below) is used quite often.

Inhibitors, or proton pump blockers - drug preparations, with the help of the treatment of diseases of the gastrointestinal tract associated with increased acidity:

Gastritis, including erosive;

Stomach and duodenal ulcers;

Duodenitis - inflammation of the mucous membrane of the duodenum;

GERB - reflux disease, in which the contents of the stomach regularly throws into the esophagus, which is why the mucosa of the esophagus, trachea and pharynx is erupted;

Dyspepsia - disruption of the process of digestion, in which there is a feeling of a stitching / cutting pain in the epigastric area (solar plexus area) after meals;

The consequences of adopting non-steroidal anti-inflammatory drugs (such as "diclofenac") irritating the mucous membranes of the gastrointestinal tract;

Zolinger-Ellison syndrome - gastrone - malignant tumor causing increased secretion of hydrochloric acid.

In all these cases, the reception of proton pump inhibitors is shown.

Mechanism of action

Pills or IPP capsules are taken orally orally, dissolved in the small intestine and transferred with blood through the liver into secretory tubules, where they begin to accumulate. Due to the impact directly on the tubules, which produce hydrochloric acid, inhibitors reduce its secretion, respectively, the aggressiveness of the gastric juice decreases.

The proton pump inhibitor (a list of drugs is available on any pharmacy) is appointed by a doctor.

The mechanism of operation of all drugs of this type is the same, but the concentration of the active substance, which supports the required level of pH, and the speed of exposure is distinguished. Only a doctor can pick them up after measuring acidity, it is performed during the day. The appropriate drug is prescribed, and its effectiveness is monitored. If relief does not occur, and it is possible in the case of resistance to drugs of this kind, then you should look for a replacement.

In terms of pH, focus on the condition of the acidity of the gastrointestinal tract. Total units 14, the water is neutral, there is a middle of the acid-alkaline balance and has a pH, equal to 7. In the lower side of the side there is an acidic medium, in the upper - alkaline.

For a different type of diseases associated with the increased production of hydrochloric acid, the different value of the pH norms is characteristic. For example, a duodenal ulcer is capable of cutting down at a pH for more than 3 throughout the day, and to kill the bacterium Helicobacter pylori, a weakly acidic medium is necessary, where the pH is more than 5.

According to the RN and the established diagnosis, the doctor prescribes one or another drug from the proton pump blockers in a certain dosage for a certain period.

Duration of reception

The course of treatment can be several months and even years. For example, the instruction "Rabeprazole" describes the duration of the reception. Safety for the body, since they act locally and do not cause addiction, that is, after the course end, you can not be afraid of the so-called "cancellation syndrome". This type of drugs does not flick the disease, and completely heals it.

Now it is clear what is a proton pump inhibitor. The list of drugs is very extensive.

Group of proton pump blockers

- "omeprazole-acri".

- "Omeprazol-Richter" is the most potent option.

- "Omeprazole Sandoz". The combined agent used rather to adjust the production of hydrochloric acid and the functions of the gastrointestinal tract.

For a long time, it is known that "omeprazole" is an inhibitor of proton pump, but today it is preferred to be prescribed less often, since the preparations of the new generation differ in the better way of both performance and the manifestation of side effects.

Introduction is allowed not only orally, but also intravenously, which helps to obtain a quick result. Recurrements of diseases were not marked for 10 years of patient observations.

Pantoprazole

Each package is available to the preparation "Pantoprazole" instructions for use. The price of the drug averages 130 rubles.

"Pantoprazole" with great accuracy, but prescribed for 2 and 3 trimesters of pregnancy, if the potential benefits are expected much higher than the risk for the child. Tests for pregnant women were not carried out, but animals had no negative impact on the fruit.

Before applying "omeprazole" and "Pantoprazole", it is necessary to carefully read with an extensive list of drug interactions and consult with the doctor if the reception of a drug from this list is planned simultaneously with other drugs. Analogue - "Nalpaza".

Why do this drug appoint? This is also a proton pump inhibitor. Produced in two forms - in pills and ampoules for injections. But in fact, the ampoules are the lyophilisate from which the injection solution is prepared. Most often is prescribed for peptic ulcer, but successfully applies with other diseases of the gastrointestinal tract.

Thanks to the juice is produced in a smaller volume, the mucosa is so much irritated. If there are ulcers and erosion, then they are gradually headlong. With this perfectly copes "Nalpaz". For which the drug is prescribed, it has become clearer. Analogs - Lanzar-Sanovel, "Epicur", "Acrimanz", and others. Restantly applied in the treatment of pregnant women and children; a drug.

"Rabeprazole" is another drug from the group of proton pump blockers.

The instruction indicates that it is incompatible with liquid antacids. Action is increasing with simultaneous reception with "warfarin", "diazepam", "theophylline" and "phenytino". Analogs - "Beret", "Zolyspan", "Noflyux", "Pariet", "Relvestle", "Hailasezol" and others.

"Lansoprazole" is an effective drug for diseases of the gastrointestinal tract. Produces blocking of gastric juice production. This confirms the instruction to the drug "Lansoprazole". In addition, the medication struggles with the bacterium Helicobacter Pilori. Specific antibodies are produced strongly due to the action of the drug. The prepaption is most of the first few days from the beginning of the reception. Analogs - "Emanner", "Nexium", "Losek", "Sanmpraz" and others. Some medications accepted simultaneously with Lansoprazole, are able to increase its concentration in blood plasma and strengthen the effect. This is "imipramine", "clomipramine", "cytalopram". "Diazepam" and "Phoenitoine" increase the content slightly, and "ketoconazole", "Iratenazole" and "Clarithromycin" helps to reduce the effectiveness of the drug. This describes the "Lansoprazole" instruction for use.

"Ezomeprazole" is a good preparation with ulcer of the stomach and duodenal. You can apply with antibiotics. Heals in the phase of exacerbation of diseases and is used for prevention. Presents the reproduction of Helicobacter pylori. The drug "Ezomeprazole" (capsules and injection mortar) is used within a month in the dosage of 40 mg per day. For prevention dose can be reduced by half.

Precautions

Against the background of treatment with the protonic pump blockers, the symptoms of cancer can become unfriendly, so before the start of therapy it is necessary to pass the survey to eliminate the occurrence of tumors. In addition, urgent research will need with frequent vomiting, especially with blood, chair disorder and change its color and odor, as well as cutting weight loss. So, with caution it is worth taking "Rabeprazole Sodium".

This group of drugs, according to recent studies, increases the fragility of the bones, respectively, the risk of fractures, and also provokes associated diarrhea (that is, caused by the reception of certain drugs), hypomagnation and the manifestation of dementia in old age.

For this reason, the doctor must first assign the highest possible dosage or, if possible, a short rate of reception and observe the effect.

Application with antibiotics

Proton pump inhibitors (new generation drugs) are used in the complex treatment of diseases caused by the bacterium Helicobacter pylori, which can contribute to the occurrence of the problems of the gastrointestinal tract, and provoke recurrences already, seemingly cured diseases. In this case, antibiotics, mostly tetracycline row are added to the treatment.

This is a group of strong antibiotics, so in no case cannot be prescribed them yourself.

Side effects

As with any medication, the proton pump blockers have a number of possible side effects:

• increasing drowsiness - therefore, this type of drugs is prohibited from being taken to persons whose activity requires attention and speed of reactions, such as drivers;

• headaches reaching migraines - contrast to the reception simultaneously with IPPs, but the doctor's consultation is desirable;

• dizziness and weakness;

• pain in the legs, spine, joints;

• digestion disorder - diarrhea or constipation, nausea;

• a change in taste;

• dry mouth;

• allergic reactions - urticaria, itching;

• slowdown in the formation of blood cells - leukocytes and platelets;

• increased sweating, chills.

In these cases, the attending physician, which, as a rule, is appointed another suitable drug IPP.

It is necessary to take into account that side effects are quite rare and most often expressed weakly, therefore, under the control of the doctor, further use is usually quite possible.

If proton pump inhibitors are used (new generation drugs), then there are practically no side effects.

Contraindications

Common contraindications for all proton pump inhibitors are:

The period of lactation and pregnancy, especially 1 trimester, the use of some preparations of this group of 2 and 3 trimesters is possible with the consent of the doctor. These drugs are extremely bioavailable, that is, they can penetrate the fabrics, including and accumulating in breast milk. And although there are no confirmed data on the dangers of these funds for the fetus, there is no reverse information, with the exception of animal experiments.

Children's age up to 12 years, since the work of their internal secretion glands is under development and formation, so any intervention can provoke a failure.

Allergies or increased sensitivity to the components of the drug.

For example, all this describes the Panoprazole preparation instructions for use.

Price

Prices for proton pump bloculator drugs fluctuate widely, but they are quite accessible. The average cost is from 90 rubles. for packaging "omeprazole" up to 500 rubles. For the packaging of other drugs of a new generation.

The price also depends on the number of capsules / tablets in the package and the manufacturer. For example, Russian generics can be bought for 20-100 rubles, but it should be understood that generics are not original means. They most often lower efficiency and worse portability, more likely to occur by side effects.

Comments:

• What substances relate to the family
• How do drugs of this group work
• When drug preparations are prescribed
• To whom the drug is contraindicated

Proton pump inhibitors, preparations intended for blocking the formation of hydrochloric acid in the stomach, are often used in gastroenterology. These means suppress the operation of the proton pump in the cell membrane producing hydrochloric acid for digestion. A new type of medicine was able to change the situation in the treatment of gastrointestinal diseases.

Suppression of biochemical processes with active substances occurs at the level of secretory cells.

The first medicine, which has a property to significantly reduce the production of hydrochloric acid, intervening in the operation of cell membranes, was omeprazole.

Now it is the most common preparation for treatment at home, but has side effects that do not allow it to use for long-term therapy. Then other active substances with a similar action were found. In the pharmacy you can buy new drugs, with the best effect and with fewer side effects. For the treatment of gastritis complicated by infection, combined drugs are used, which includes not only inhibitors, but also antibacterial agents.

What substances relate to the family

After omeprazol passed all the tests and was released on the market, many people got the opportunity to get rid of the stomach diseases, which were aggravated at the moment of activating cells responsible for the high concentration of hydrochloric acid. The resulting effect exceeded all the results, which were observed when applying other antisecretory agents. Due to the fact that in patients who used the omeprazole for a long time, the resistance of cells to this active substance began to be revealed, there was a need for drugs such, but with the lack of side effects. In the laboratories of many largest pharmacological companies, work began on the creation of substances of similar action.

Modern pharmaceuticals offers patients with 5 active substances that significantly improve the condition of a person suffering from acid-dependent diseases of the digestive organs:

• omeprazole;
• lansoprazole;
• pantoprazole;
• rabeprazole;
• ezomeprazole.

The use of these substances does not eliminate patients from seasonal aggravation of peptic disease, if it was caused by the Helicobacter Pylori bacterium, irritating the stomach wall. Each course of treatment gives only a long remission. For complete recovery from ulcerative gastritis, a comprehensive treatment should be carried out, in which the proton pump inhibitor must include.

All active substances relating to the same group have a continuous effect on the cells, but the later they were open, the better their impact on the body. The most effective is pantoprazole, which is used for hospital treatment.

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How do drugs of this group work

The proton pump inhibitors are actively prescribed by gastroenterologists for the treatment of acid-dependent states. They are 95% help to achieve a stealing remission in the formation of a duodenal ulcer and reflux, which observes the cast of eaten food into the esophagus from the stomach.

All active substances are absorbed in the small intestine and accumulate as much as possible in a plasma in 3.5 hours after receiving the capsule. They enroll in the station of parietal cells, where they start their work on blocking their activity.

The bioavailability of famous proton pump inhibitors is different, but stable. It can not change either eating or antacid drugs. Omeprazole after the second reception of a single dose reduces it, Esomeprazole increases, and the remaining three active substances do not change this indicator from the first to the last dose. The decay of active substances occurs in the liver. The resulting metabolites are non-toxic, are derived from the body with urine. This allows the use of drugs for a long time if the condition of the body requires.

Omeprazole acts in the body no more than 14 hours. And it makes it take 2 capsules per day when the symptoms return to the increase in the level of acidity in the stomach. With prolonged use to this active substance, the immunity of the body is produced, or resistance.

Ezomeprazole is an isomer omeprazole, which has greater metabolic stability. It can control the production of hydrochloric acid within 24 days without causing addiction or other side effects. Having bought the drug in the pharmacy with this active substance, the patient must take 1 capsule per day, which is very convenient.

Pantoprazole, having pH 5.0, is most stable and is weaker than activated. Its high bioavailability allows drugs with this active substance for injection patients in the hospital during the treatment of severe stomach lesions. Pantoprazole reacts with antibacterial drugs in complex therapy, and it enhances its therapeutic effect. This active substance showed a good result in the treatment of bronchial asthma.

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When drug preparations are prescribed

The gastroenterologist recommends that proton pump inhibitors in the detection of any acid-dependent disease of the digestive organs. To states, when the tools that suppress the processes of excessive production of hydrochloric acid are especially useful, belong:

• hyperacid gastritis at which the walls of the stomach are inflated;
• the use of hormone-containing drugs;
• treatment of non-steroidal anti-inflammatory drugs;
• damage to the lower esophageal sphincter;
• regular casting from the stomach in the esophagus.

Blockers of the proton pump are used in the complex treatment of pancreatitis, biliary disease and other diseases of the digestive organs, which entail an increase in the level of acid.

Preparations of this group in a complex with antibacterial active agents accelerate the treatment of diseases of the digestive tract caused by Helicobacter Pylori. Pharmacists offer compound combinations of inhibitors with metronidazole, tinidazole, amoxicillin and clarithromycin.

Such complex compositions can be taken only after the recommendation of the doctor he does after the diagnosis.

The selection of the active substance is carried out after measuring the acidity in the upper patient's stomach departments. Treatment is adjusted if the reaction to the effect of the drug does not bring results. This is explained by the individual characteristics of the body and cell resistance to the selected active substance. The stability of cells to the proton pump inhibitor can be caused by the genetic characteristics of the body or formed during the course of the disease. The doctor at the beginning of treatment determines the individual reception rhythm and clarifies the doses of drugs using the analysis of the intragastric pH. The gastroenterologist can designate original lansoprazole preparations, pantoprazole or other similar means, because generic inhibitors may contain less active substance, and this reduces the expected effectiveness of treatment.