Proton pump inhibitor: list of drugs, mechanism of action, reviews

More than 90% of the population suffers from problems with digestion, heartburn and gastritis, but few know that drugs designed to alleviate the condition have long existed and are actively used in medical practice in cases where antacids do not help. We'll figure out what an inhibitor of the proton pump is, we'll also consider the list of drugs.

Where did the pump come from?

The proton pump, which is also a 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 process of digesting food. However, it often happens that the acid begins to be produced in large quantities, which leads to unpleasant and painful sensations in the stomach.

Indications for use

The proton pump inhibitor (the list of drugs will be listed below) is used quite often.

Inhibitors, or blockers of the proton pump - drugs, with the help of which the treatment of diseases of the gastrointestinal tract associated with high acidity:

- gastritis, including erosive;

- stomach ulcers and duodenal ulcers;

- duodenitis - inflammation of the mucous membrane of the duodenum;

- GERD - reflux disease, in which the contents of the stomach are regularly thrown into the esophagus, because of which the mucous membrane of the esophagus, trachea and pharyngea is eroded over time;

- dyspepsia - disturbances in the digestive process, in which there is a sensation of stitching / cutting pain in the epigastric region (area of the solar plexus) after eating;

- the consequences of taking non-steroidal anti-inflammatory drugs (such as "Diclofenac"), irritating 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, proton pump inhibitors are indicated.

Mechanism of action

Tablets or capsules PPI are taken orally, dissolved in the small intestine and transferred with blood through the liver into the secretory tubules, where they begin to accumulate. Due to the effect directly on the tubules, which produce hydrochloric acid, the inhibitors reduce its secretion, respectively, the aggressiveness of the gastric juice decreases.

The proton pump inhibitor (a list of drugs available in any pharmacy) is prescribed by a doctor.

The mechanism of operation of all preparations of this type is the same, but the concentration of the active substance that maintains the necessary pH level and the rate of action varies. They can be picked up only by a doctor after carrying out acidity measurements, it is performed within 24 hours. Next, a suitable drug is prescribed, and its performance is monitored. If there is no relief, and this is possible in case of resistance to drugs of this kind, then a substitute should be sought.

The pH is based on the state of acidity of the gastrointestinal tract. Total units 14, the water is neutral, located in the middle of the acid-base balance and has a pH of 7. The acid side is the lower side of the water, the alkaline side is the upper side.

For different types of diseases associated with increased production of hydrochloric acid, different values of pH values are characteristic. For example, a duodenal ulcer can heal at a pH greater than 3 throughout the day, and to kill a Helicobacter pylori bacterium, a weakly acidic medium is required where the pH is greater 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 and even years. For example, to the drug "Rabeprazole" instruction and describes the duration of admission. Proton pump inhibitors are safe for the body, since they act locally and do not cause habituation, that is, after the end of the course one can not be afraid of the so-called "withdrawal syndrome". This type of medicines does not drown out the disease, but completely cures it.

Now it is clear what an inhibitor of the proton pump is. The list of drugs is very extensive.

Group of proton pump blockers

"Omeprazole" is a known drug. Available for sale:

"Omeprazole Acry."

- "Omeprazol-Richter" - the most potent option.

"Omeprazole Sandoz." A combined agent, used rather to regulate the production of hydrochloric acid and the functions of the gastrointestinal tract.

For a long time it is known that "Omeprazole" is an inhibitor of the proton pump, but today it is preferred to be prescribed less often, as the new generation drugs differ for the better both by the effectiveness and by the manifestation of side effects.

It is possible to administer not only orally but also intravenously, which helps to obtain a quick result. Relapses of diseases were not observed within 10 years of patient observation.

Pantoprazole

In each package there is an instruction for the use of the drug "Pantoprazole". The price of the drug is on average 130 rubles.

"Pantoprazole" with great care, but prescribed for 2 and 3 trimesters of pregnancy, if the potential benefit is supposed to be much higher than the risk for the child. Tests on pregnant women were not carried out, but the animals had no negative effect on the fetus.

Before using Omeprazole and Pantoprazole, you should carefully read the extensive list of drug interactions and consult a doctor if taking a drug from this list is planned simultaneously with other medicines. The analogue is "Nolpaz".

What is the prescription for this drug? This is also an inhibitor of the proton pump. Produced in two forms - in tablets and ampoules for injection. But in fact, ampoules are a lyophilizate from which a solution for injections is prepared. Most often it is prescribed for peptic ulcer disease, but it is also successfully used in other gastrointestinal diseases.

Due to the preparation, gastric juice is produced in a smaller volume, the mucous membrane is not so irritated. If there are ulcers and erosions, then they gradually become scarred. This is perfectly handled by "Nolpaz". For what the drug is prescribed, it became clearer. Analogues - Lanzap, Lansoff, Loensar-sanovel, Epicurus, Akrilanz, etc. It is used in the treatment of pregnant women and children, it is undesirable to use it if you can choose another drug.

"Rabeprazole" is another drug from the group of proton pump blockers.

To the preparation "Rabeprazole" the instruction indicates that it is incompatible with liquid antacids. The effect increases with simultaneous reception with "Warfarin", "Diazepam", "Theophylline" and "Phenytoin". Analogues - Beretta, Zolispan, Noflux, Pariet, Rabelok, Khairabezol, and others.

"Lansoprazole" - an effective drug for diseases of the gastrointestinal tract. Produces a blockage in the production of gastric juice. This confirms the instruction for the preparation "Lansoprazole" instruction. In addition, the medicine is fighting the Helicobacter pylori bacterium. Specific antibodies to it are produced intensively by the action of the drug. The drug works for the first few days from the beginning of the treatment. Analogues - "Emanera", "Nexium", "Losek", "Sanpraz", etc. Some drugs taken simultaneously with "Lansoprazol" are able to increase its concentration in blood plasma and enhance the effect. These are Imipramine, Clomipramine, Citalopram. "Diazepam" and "Phenytoin" increase the content slightly, and "Ketoconazole", "Itraconazole" and "Clarithromycin" contribute to a decrease in the effectiveness of the drug. So describes the "Lansoprazole" instructions for use.

"Esomeprazole" - a good drug for peptic ulcer of the stomach and duodenum. Can be used together with antibiotics. It treats in the phase of exacerbation of diseases and is used for prevention. Suppresses the reproduction of Helicobacter pylori. The drug "Esomeprazol" (capsules and solution for injections) is used for a month at a dosage of 40 mg per day. For prevention, the dose can be reduced by half.

Precautionary measures

Against the background of treatment with proton pump blockers, the symptoms of cancer can become less pronounced, therefore, before the start of therapy, it is necessary to undergo a survey in order to exclude the appearance of tumors. In addition, urgent research will be required with frequent vomiting, especially with blood, stool disorder and changes in color and odor, and severe weight loss. So, with caution should take "Rabeprazole sodium."

This group of drugs, according to recent studies, increases the fragility of bones, respectively, and the risk of fractures, and also provokes associated diarrhea (that is, caused by taking certain medications), hypomagnesemia and the manifestation of dementia in old age.

For this reason, the doctor should first prescribe the lowest possible dosage or, if possible, a short course of admission and observe the effect.

Use with antibiotics

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 problems of the gastrointestinal tract, 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 can you assign them yourself.

Side effects

As with any medicine, proton pump blockers have a number of possible side effects:

• Increased drowsiness - so this type of drugs is forbidden to persons whose activities require attention and speed of reactions, for example, to drivers;

• Headaches that reach migraine headaches - antimigraine drugs are not prohibited for admission simultaneously with PPI, but a doctor's advice is desirable;

• Dizziness and weakness;

• Pain in the legs, spine, joints;

• Indigestion - diarrhea or constipation, nausea;

• Change in taste;

• Dry mouth;

• Allergic reactions - hives, itching;

• Retardation of the formation of blood cells - leukocytes and platelets;

• Increased sweating, chills.

In these cases, it is mandatory to inform the attending physician, who, as a rule, appoints another suitable preparation of PPI.

It should be taken into account that side effects are very rare and are usually weakly expressed, therefore, under the supervision of the doctor, further use is usually possible.

If proton pump inhibitors are used (new generation drugs), then there are almost 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 medicines are extremely bioavailable, that is, they are able to penetrate through tissues, including the placental barrier, and accumulate in breast milk. And although there is no confirmed data on the harm of these funds for the fetus, there is no feedback information, except for experiments with animals.

- Children under 12 years of age, because the work of their endocrine glands is at the stage of development and becoming, so any interference can provoke a malfunction.

- Allergies or hypersensitivity to the components of the drug.

For example, all this describes the instructions for use for the preparation Pantoprazole.

Price

Prices for proton pump blocking drugs fluctuate widely, but they are quite affordable. The average cost is from 90 rubles. For the packaging of "Omeprazole" up to 500 rubles. For the packaging of other drugs of the new generation.

The price also depends on the number of capsules / tablets in the package and the country of origin. For example, Russian generics can be bought for 20-100 rubles. But you need to understand that generics are not original means. They are often less effective and less tolerable, more likely to cause side effects.

Reviews

Preparations of this group are mostly positive. They are really effective in diseases of the digestive tract. The cost is very acceptable.

There are, of course, 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 all over the world are engaged in this. About 6 years ago the drug "Dekslansoprazol" was released. It is not yet approved for use without restrictions, but gastroesophageal reflux disease with it is treated quite successfully.

At present, "Tenatoprazole" is being developed in Japan, which is positioned as the most effective proton pump blocker.

The Korean "Ilaprazole" acts much softer and faster than "Omeprazole", nevertheless in Russia, the US and the EU it is prohibited for use for unknown reasons.

Preparations of this group are taken more often 1-2 times a day, which makes their use convenient. But they should be prescribed only by a doctor after anamnesis and examination, because each drug has its own properties, and each person has his own characteristics of the course of the disease. We examined in detail the inhibitors of the proton pump. The mechanism of action is also described.