Abstract
Resume. Purpose. To study factors that significantly alter the pharmacokinetics and pharmacodynamics of proton pump inhibitors in patients with chronic gastritis and duodenal ulcer. Introduction. The problem of comparative assessment of pharmacodynamics and clinical efficacy of various proton pump inhibitors, including representatives of other pharmacological groups that affect acid production, is relevant. For such an analysis in patients suffering from various variants of acid-dependent pathology of the stomach and duodenum, it is necessary to conduct a comparative characterization of modern proton pump inhibitors in the treatment and prevention of hemorrhagic gastritis and duodenal ulcer. Material and methods. The work was carried out in the Department of Gastrointestinal and Esophageal Surgery of the State Institution «V. T. Zaitsev Institute of Gastrointestinal Medicine of the National Academy of Medical Sciences of Ukraine» with the presentation of the results of the study of the most frequently used proton pump inhibitors: omeprazole (Omez, 20 mg capsules, «Dr. Reddy’s Laboratories, Ltd», India), lansoprazole (Lancerol, 30 mg capsules, PJSC «KYIVMEDPREPARAT», Kyiv, Ukraine), esomeprazole (Nexium, film-coated tablets, «ASTRAZENECA», Great Britain), rabeprazole (Pariet, film-coated tablets, «Janssen Pharmaceutica N. V.», Belgium). Two groups of patients were studied: the main group — with gastrointestinal pathology (31 patients) and the comparison group, which was represented by 25 relatively healthy individuals. Research results. Two-time studies of the pharmacokinetics of proton pump inhibitors were conducted in patients with incomplete remission of peptic ulcer disease, since it was proven on the example of lancerol that the decrease in the bioavailability of proton pump inhibitors persists after ulcer healing, and conducting a two-time pharmacokinetic study, with the exception of taking antiulcer drugs between them during exacerbation, is unethical. When studying resistance to acid production blockers using the virtual NBI-chromoendoscopy method, it was shown that in non-operated patients with peptic ulcer disease on the background of taking proton pump inhibitors, a single case of resistance (to lancerol) was observed. At the same time, when using famotidine, resistance was observed in 13 out of 50 patients. In operated patients, we did not observe cases of resistance to proton pump inhibitors (esomeprazole). Conclusions. Esomeprazole and rabeprazole have higher clinical efficacy in the treatment of chronic gastritis compared to omeprazole and lancerol. In duodenal ulcer, the rate of ulcer healing is the same with omeprazole, lancerol, esomeprazole and rabeprazole and exceeds the rate of healing with famotidine.
Published Version
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