Omeprazole in Zollinger–Ellison Syndrome

Abstract

We studied the effect of omeprazole, a benzimidazole inhibitor of gastric acid secretion, in patients with Zollinger-Ellison syndrome. In five patients ingestion of 80 mg of omeprazole inhibited gastric acid secretion by 26 to 100 per cent after 6 hours and by 76 to 100 per cent after 24 hours. Seven patients were continuously treated with omeprazole once or twice daily for 8 to 19 months (average, 14). Six of these seven had symptoms that were resistant to high doses of histamine H2-receptor antagonists, and the seventh could not take high doses of cimetidine because of a possible drug-related increase in the serum creatinine concentration. Symptoms resolved in all patients within two weeks, and peptic lesions were healed at endoscopy after four weeks. All patients remained free of symptoms, and gastric acid secretion continued to be markedly inhibited by omeprazole therapy. We conclude that omeprazole is a potent and long-acting antisecretory drug in patients with Zollinger-Ellison syndrome and that it is effective in patients whose peptic-ulcer disease is relatively resistant to treatment with histamine H2-receptor antagonists. Its safety and effectiveness in long-term therapy remain to be assessed.

Pharmacokinetics of intravenous omeprazole in children

“…At the time of the study, patients 7, 8 and 9 were taking potentially nephrotoxic agents (amphotericin B, amikacin, cyclosporin, vancomycin). Patient 10 was haemodial- (10,11,12,13) had plasma creatinine levels above 100 gmol' 1-1. All except patient 13 had normal hepatic function.…”

“…In adults, its efficacy has been demonstrated for the treatment of reflux oesophagitis and ulcers, especially gastric duodenal ulcers refractory to H2-receptor blockers, when administered intravenously [6,7,8] or orally [9,10,11], and in the short-term and long-term treatment of Zollinger-E1-lison syndrome [12].…”

Inhibition of human liver cytochrome P‐450 by omeprazole.

“…Benzimidazoles are inhibitors of the H+-K+ ATPase which is located in the parietal cell and is involved in the final step of proton secretion. Clinical investigations in Europe and Australia have shown omeprazole to be a potent antiulcer drug (Lamers et al, 1984). One of the plasma metabolites of omeprazole in man is its corresponding sulfone (Mihaly et al, 1983), the formation of which is catalysed by the cytochrome P-450 linked monooxygenase system in the liver (Testa & Jenner, 1976 (Gugler & Jensen, 1984).…”

Medical Management of Acid-Peptic Disorders of the Stomach

“…Before the advent of PPIs, medical therapy had little to offer in either the short-term management of the preoperative patient or in the long-term management of inoperable patients. With omeprazole and its related successors, acid secretion can now be effectively controlled in these patients for long periods of time if necessary [15][16][17][18]. Intravenous administration of PPIs is also efficacious in the perioperative patient [19].…”