Pharmacologic Properties of Proton Pump Inhibitors

Abstract

Since their introduction into clinical practice in the 1980s, proton pump inhibitors (PPIs) have proved to be of enormous value in the management of acid peptic disorders. They have become the treatment of choice for most, if not all, acid-related gastrointestinal disorders, including gastroesophageal reflux disease, peptic ulcer, and Zollinger-Ellison syndrome. With approval of an intravenous formulation, the benefits of PPIs are extended to critically ill patients for whom oral drug administration is often unsuitable. Five PPIs are approved for clinical use in the United States. Although they share a common core structure and mechanism of action, it is important to understand the general pharmacology of these agents and how they differ from histamine2-receptor antagonists in order to optimize PPI therapy.

Evaluation for Protective Effect of Rutin, a Natural Flavonoid, against HCl/Ethanol-Induced Gastric Lesions

“…The formation of gastric mucosal lesions by necrotizing agents such as HCl and ethanol has been known to be associated with the depression of gastric defensive mechanisms (Kinoshita et al, 1995). Therefore, the regulators such as proton pump inhibitors for the acid production accelerate the healing of gastric ulcers and gastritis by potent and long-lasting anti-secretory actions (Welage, 2003), and are widely used in clinic (Pisegna, 2002). However, this result suggests that the mechanism of rutin to inhibit gastric ulcer and gastritis may not be involved in the suppression of aggressive factors such as the inhibition of gastric acid secretion.…”

Protective effects of neohesperidin and poncirin isolated from the fruits of Poncirus trifoliata on potential gastric disease

“…of gastric mucosal lesions by necrotizing agents such as HCl and ethanol is known to be associated with the depression of gastric defensive mechanisms (Kinoshita et al, 1995). Therefore, regulators such as proton pump inhibitors for acid production accelerate the healing of gastric ulcers and gastritis by potent and long-lasting antisecretory actions (Welage, 2003), and are widely used in the clinic (Pisegna, 2002). Additionally, the antiinflammatory activity of bioflavonoid hesperidin elucidated that the majority of antiinflammatory agents have deleterious actions on stomach mucosa through inhibition of nitric oxide (NO) and inflammatory mediator production, such as tumor necrosis factor-a (TNF-a) and interleukin-12 (IL-12) (Rao et al, 2008).…”

Anti-gastritic Effects of Magnolol and Honokiol from the Stem Bark of Magnolia obovata

“…The formation of gastric mucosal lesions by necrotizing agents such as HCl and ethanol has been shown to be associated with depression of gastric defensive mechanisms (Kinoshita et al, 1995). Therefore, acid production regulators such as proton pump inhibitors widely used in clinic (Pisegna, 2002), appear to accelerate the healing of gastric ulcers and gastritis by potent and longlasting antisecretory actions (Welage, 2003). Thus these results suggest that the mechanism of honokiol, isolated from MB, by which it inhibited gastric ulcer and gastritis may be due to suppression of aggressive factors (i.e., inhibition of gastric acid secretion) and in turn, augmentation of defensive factors, like as proton pump inhibitors.…”