Inhibition of Pentagastrin-Stimulated Gastric Acid Secretion by Pantoprazole and Omeprazole in Healthy Adults

Abstract

Our objective was to compare the onset and duration of a single dose of pantoprazole or omeprazole on maximally stimulated gastric acid secretion. This double-blind, randomized, placebo-controlled study involved 36 healthy adults and utilized continuous pentagastrin infusion to stimulate acid secretion after administration of pantoprazole, 40 mg, omeprazole, 20 mg, or placebo. Gastric aspirates were collected over 24 hr and analyzed for volume, pH, and hydrogen ion concentration, and gastric acid outputs (GAO) were calculated. Comparison between GAO and intragastric pH was performed. Pantoprazole resulted in significantly greater inhibition of GAO than omeprazole. Mean cumulative 24-hr GAO was 164 +/- 130 mEq for pantoprazole versus 283 +/- 159 mEq for omeprazole (P = 0.031). Pantoprazole patients reached and maintained GAO levels below the 10-mEq/hr threshold at 5.7 hr, whereas omeprazole patients never reached this threshold. We conclude that pantoprazole significantly suppressed gastric acid secretion compared to omeprazole. Comparisons between pH and GAO showed that GAO was a more appropriate measure of gastric acid secretion than intragastric pH.

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“…The supernatant was then analysed for determination of pH according to the method of Hara et al (16), free and total acid concentrations were estimated by using the method of Pratha et al (17) and pepsin concentrations were determined by a modifi ed spectrophotometric method (18).…”

Oral pantoprazole in the form of granules or tablets are pharmacodynamically equivalent in suppressing acid output in patients with gastro‐oesophageal reflux disease and a history of erosive oesophagitis

“…MAO is the maximum gastric acid (mmol/h) that is secreted after a potent stimulus for the secretion of gastric acid. In a previous study, pantoprazole patients reached and maintained GAO levels below the 10.0 mmol/h threshold at 5.7 h after a single oral dose 9 …”