More than 90% of the population suffers from digestive problems, heartburn, and gastritis, but few know that medications designed to alleviate the condition have long existed and are actively used in medical practice in cases where antacids do not help. We will understand what a proton pump inhibitor is, a list of drugs will also be considered.
Where did the pump come from in the human body?
The proton pump, also known as the proton pump, is an enzyme protein that promotes the production of
hydrochloric acid in the stomach. This is a necessary and most important action for the digestion process. However, it often happens that acid begins to be produced in large quantities, which entails unpleasant and painful sensations in the stomach.
Indications for use
A proton pump inhibitor (a list of drugs will be listed below) is used quite often.
Inhibitors, or proton pump blockers, are drugs that treat gastrointestinal diseases associated with high acidity:
- gastritis, including erosive;
- ulcers of the stomach and duodenum;
- duodenitis - inflammation of the mucous membrane of the duodenum;
- GERD - a reflux disease in which the contents of the stomach are regularly thrown into the esophagus, due to which the mucous membrane of the esophagus, trachea and pharynx corrodes over time;
- dyspepsia - digestive disorders, in which there is a sensation of stitching / cutting pain in the epigastric region (the area of the solar plexus) after eating;
- the consequences of taking non-steroidal anti-inflammatory drugs (such as Diclofenac) that irritate the mucous membranes of the gastrointestinal tract;
- Zollinger-Ellison syndrome - gastrinoma - a malignant tumor that causes increased secretion of hydrochloric acid.
In all these cases, the use of proton pump inhibitors is indicated.
Mechanism of action
IPP tablets or capsules are taken orally, dissolved in the small intestine and transported with blood through the liver to the secretory tubules, where they begin to accumulate. Due to the effect directly on the tubules, which produce hydrochloric acid, inhibitors reduce its secretion, and accordingly, the aggressiveness of gastric juice decreases.
A proton pump inhibitor (a list of drugs is available at any pharmacy) is prescribed by a doctor.
The mechanism of operation of all drugs of this type is the same, but the concentration of the active substance, which maintains the required pH level, and the speed of exposure differ. Only a doctor can pick them up after taking acidity measurements; it is performed within 24 hours. Next, a suitable drug is prescribed, and its effectiveness is monitored. If relief does not come, and this is possible in the case of resistance to drugs of this kind, then you should look for a replacement.
In terms of pH, they are guided by the state of acidity of the gastrointestinal tract. There are a total of 14 units, water is neutral, located in the middle of the acid-base balance and has a pH of 7. The acidic medium goes to the lower side of the water, and the alkaline to the upper.
For different types of diseases associated with increased production of hydrochloric acid, different pH values are characteristic. For example, a duodenal ulcer can heal at a pH of more than 3 throughout the day, and in order to kill the Helicobacter pylori bacterium, a slightly acidic environment is needed, where the pH is more than 5.
According to the norm of pH and the established diagnosis, the doctor prescribes this or that drug from the group of proton pump blockers in a certain dosage for a certain period.
Duration of Admission
The course of treatment can be several months or even years. For example, for the drug "Rabeprazole", the instruction describes the duration of administration. Proton pump inhibitors are safe for the body, because they act locally and are not addictive, that is, after the course is over you can not be afraid of the so-called “withdrawal syndrome”. This type of drug does not drown out the disease, but completely cures it.
Now it’s clear what a proton pump inhibitor is. The list of drugs is very extensive.
Proton Pump Blocker Group
Omeprazole is a known drug. Available for sale:
“Omeprazole Acre.”
- Omeprazole Richter is the most potent option.
“Omeprazole Sandoz.” A combination drug that is used rather to regulate the production of hydrochloric acid and the functions of the gastrointestinal tract.
It has long been known that Omeprazole is a proton pump inhibitor, but today it is preferred to prescribe it less frequently, since new generation drugs differ for the better both in their effectiveness and in the manifestation of side effects.
Administration is allowed not only orally, but also intravenously, which contributes to a quick result. Relapses were not observed within 10 years of patient follow-up.
Pantoprazole
In each package there is an instruction for use for the Pantoprazole preparation. The price of the drug averages 130 rubles.
"Pantoprazole" with great accuracy, but prescribed during the 2nd and 3rd trimesters of pregnancy, if the potential benefit is expected to be much higher than the risk to the baby. Tests on pregnant women were not conducted, but in animals there was no adverse effect on the fetus.
Before using Omeprazole and Pantoprazole, you must carefully read the extensive list of drug interactions and consult a doctor if you are planning to take any drug from this list at the same time as other drugs. The analogue is Nolpaza.
Why is this drug prescribed? It is also a proton pump inhibitor. Available in two forms - tablets and ampoules for injection. But in fact, ampoules are a lyophilisate from which a solution for injection is prepared. It is most often prescribed for peptic ulcer disease, but it is also successfully used for other gastrointestinal diseases.
Thanks to the drug, gastric juice is produced in a smaller volume, the mucous membrane is not so irritated. If there are ulcers and erosion, then they gradually heal. “Nolpaza” copes with this perfectly. Why is the drug prescribed, it has become clearer. Analogs - “Lanzap”, “Lansofed”, “Lohenzar-sanovel”, “Epicurus”, “Acrylanz” and others. It is used limitedly in the treatment of pregnant women and children, use is undesirable if you can choose another drug.
Rabeprazole is another drug in the proton pump blocker group.
For the preparation "Rabeprazole", the instruction indicates that it is incompatible with liquid antacids. The effect is enhanced while taking with "Warfarin", "Diazepam", "Theophylline" and "Phenytoin." Analogs - "Bereta", "Zolispan", "Noflux", "Pariet", "Rabelok", "Khairabesol", etc.
"Lansoprazole" is an effective drug for diseases of the gastrointestinal tract. It blocks the production of gastric juice. This confirms the instructions for the drug "Lansoprazole". In addition, the drug fights the Helicobacter pylori bacterium. Specific antibodies to it are produced intensely due to the action of the drug. The drug works the first few days from the start of administration. Analogues are Emanera, Nexium, Losek, Sanpraz and others. Some drugs taken simultaneously with Lansoprazole can increase its concentration in the blood plasma and enhance the effect. This is “Imipramine”, “Clomipramine”, “Citalopram”. Diazepam and Phenytoin increase the content slightly, and Ketoconazole, Itraconazole and Clarithromycin decrease the effectiveness of the drug. So describes "Lansoprazole" instructions for use.
Esomeprazole is a good drug for peptic ulcer and duodenal ulcer. It can be used with antibiotics. It treats in the phase of exacerbation of diseases and is used for prevention. Suppresses reproduction Helicobacter pylori. The drug “Esomeprazole” (capsules and solution for injection) is used for a month at a dosage of 40 mg per day. For prevention, the dose can be halved.
Precautionary measures
Against the background of treatment with proton pump blockers, the symptoms of oncological diseases can become mild, therefore, before the start of therapy, it is necessary to undergo examination to exclude the occurrence of tumors. In addition, an urgent study will be required with frequent vomiting, especially with blood, an upset stool and a change in its color and smell, as well as a sharp weight loss. So, with caution should take "Rabeprazole sodium."
This group of drugs, according to recent studies, increases bone fragility, respectively, and the risk of fractures, and also provokes associated diarrhea (that is, caused by the use of certain drugs), hypomagnesemia and the manifestation of dementia in old age.
For this reason, the doctor should first prescribe the lowest possible dosage or the shortest possible course of admission and observe the effect.
Antibiotic use
Proton pump inhibitors (new-generation drugs) are used in the complex treatment of diseases caused by the Helicobacter pylori bacterium, which can both contribute to the occurrence of gastrointestinal tract problems and provoke relapses of seemingly cured diseases. In this case, antibiotics, mainly tetracycline, are added to the treatment.
This is a group of strong antibiotics, so in no case should you prescribe them yourself.
Side effects
As with any medicine, proton pump blockers have a number of possible side effects:
- increased drowsiness - therefore, this type of drug is prohibited for people whose activities require attention and speed of reactions, for example, drivers;
- headaches reaching migraines - anti-migraines are not forbidden to be taken simultaneously with PPI, but a doctor’s consultation is advisable;
- pain in the legs, spine, joints;
- digestive disorders - diarrhea or constipation, nausea;
- allergic reactions - urticaria, itching;
- slowing down the formation of blood cells - white blood cells and platelets;
- increased sweating, chills.
In these cases, the attending physician is required to be notified, who usually prescribes another suitable PPI drug.
It must be borne in mind that side effects are quite rare and most often weakly expressed, therefore, under the supervision of a doctor, further use is usually quite possible.
If proton pump inhibitors (new generation drugs) are used, then there are practically no side effects.
Contraindications
Common contraindications for all proton pump inhibitors are:
- Lactation and pregnancy, especially 1 trimester, the use of certain drugs of this group in the 2nd and 3rd trimesters is possible with the consent of the doctor. These drugs are extremely bioavailable, that is, they are able to penetrate tissues, including the placental barrier, and accumulate in breast milk. And although there is no confirmed data on the harm of these funds to the fetus, there is no feedback, except for experiments with animals.
- Children under 12 years of age, since the work of their endocrine glands is in the development and formation stage, so any intervention can provoke a malfunction.
- Allergy or hypersensitivity to the components of the drug.
For example, all this is described for the Pantoprazole preparation by the application instruction.
Price
The prices of proton pump blockers vary widely, but they are affordable. On average, the cost is from 90 rubles. for the packaging of Omeprazole up to 500 rubles. for packaging other new generation drugs.
The price also depends on the number of capsules / tablets in the package and the country of manufacture. For example, Russian generics can be bought for 20-100 rubles, but you need to understand that generics are not original means. They often have lower efficacy and worse tolerance, more likely to cause side effects.
Reviews
Drugs in this group mainly cause positive reviews. They are really effective for gastrointestinal diseases. The cost is very reasonable.
Of course, there are some side effects, such as diarrhea. But they appear in rare cases, and if you choose the right dosage, then they will not be at all.
Conclusion
Proton pump inhibitors are constantly being improved. Scientists from different countries of the world are engaged in this. About 6 years ago, the drug “Dexlansoprazole” was released. It is not yet approved for use without restrictions, but gastroesophageal reflux disease with its help is treated quite successfully.
Currently in Japan, “Tenatoprazole” is being developed, which is positioned as the most effective proton pump blocker.
Korean "Ilaprazole" acts much softer and faster than "Omeprazole", however, in Russia, the USA and the EU it is banned for use for unknown reasons.
Preparations of this group are most often taken 1-2 times a day, which makes their use convenient. But only a doctor should prescribe them after collecting an anamnesis and an examination, because each drug has its own properties, and each person has their own characteristics of the course of the disease. We examined proton pump inhibitors in detail. The mechanism of action is also described.