Proton Pump Inhibitors: Review of Emerging Concerns

Treatment with clopidogrel and proton pump inhibitors in combination: a review of emerging evidence

Proton pump inhibitors often are prescribed in combination with clopidogrel to decrease risk of gastrointestinal bleeding after acute coronary syndrome. Clopidogrel is a prodrug that has to be metabolized in the liver to generate the active metabolite. Both medications are metabolized largely by the CYP2C19 enzyme; therefore, concerns exist that a drug-drug interaction during concomitant treatm...

Proton Pump Inhibitors: Omeprazole

Oral Proton Pump Inhibitors

There is currently a lack of evidence to suggest superior clinical efficacy of one oral proton pump inhibitor over any other. Proton pump inhibitors display similar doseresponse relationships with similar potencies and efficacies at the equivalent dose. The decision to select one proton pump inhibitor over another is likely to be based on the agents’ licensed indication, patient tolerability an...

Intravenous proton pump inhibitors.

Intravenous (IV) administration of a proton pump inhibitor (PPI) is a faster way to achieve gastric acid suppression than oral administration of the same agent. Peak suppression after IV administration occurs within hours, compared with several days later after oral administration. Thus the IV route of administration offers a faster onset of gastric suppression, achievement of intragastric pH c...

Review article: the clinical pharmacology of proton pump inhibitors.

Proton pump inhibitors inhibit the gastric H+/K+-ATPase via covalent binding to cysteine residues of the proton pump. All proton pump inhibitors must undergo acid accumulation in the parietal cell through protonation, followed by activation mediated by a second protonation at the active secretory canaliculus of the parietal cell. The relative ease with which these steps occur with different pro...