Med. praxi. 2012;9(11):423-426

Proton pump inhibitors in peptic lesions therapy

prof.MUDr.Petr Dítě, Ph.D.¹, MUDr.Radek Kroupa, Ph.D.², MUDr.Ivo Novotný, CSc.³, MUDr.Martina Jelšíková⁴

¹ Akademické centrum digestivní onkologie Lékařské fakulty Ostrava

² Interní gastroenterologická klinika, FN Brno

³ Endoskopické oddělení, Masarykův onkologický ústav Brno

⁴ Interní klinika, FN Ostrava

The treatment of diseases related to the presence of gastric hydrochloric acid has gone through a tumultuous development since 1910

when antacids were first introduced in clinical practice.

Recently, the drugs referred to as proton pump inhibitors have undoubtedly been the most effective drugs in terms of the intensity and

duration of suppression of gastric hydrochloric acid. Their division into first- and second-generation drugs mainly reflects the changes

in their pharmacokinetics and pharmacodynamics.

The drugs are administered as a prodrug and only converted into an active form in the parietal cell of the gastric mucosa. Their metabolism

through the hepatic cytochrome p450 is a source of possible drug interactions that only minimally involve pantoprazole, due to

its metabolic conversion into sulphate.

An advantage of the drugs is that their secretory function is suppressed by blocking the intracellular structure, referred to as K-ATPase

(proton pump), and not by blocking only some of the receptors on the surface of the parietal cell, e. g. the H2 receptor.

In addition to possible interactions, the individual inhibitors clearly differ in terms of the rapidity of onset of the suppressor effect or

the duration of suppression of gastric hydrochloric acid; however, it is generally true that all these drugs are exceedingly effective and

safe. Side effects, particularly with long-term medication, have been reported, but are not numerous.

Keywords: proton pump inhibitors, prodrug, K-ATPase, drug interactions, side effects of PPI treatment

Published: December 1, 2012  Show citation