Document Detail


Acid peptic diseases: pharmacological approach to treatment.
MedLine Citation:
PMID:  21822447     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Acid peptic disorders are the result of distinctive, but overlapping pathogenic mechanisms leading to either excessive acid secretion or diminished mucosal defense. They are common entities present in daily clinical practice that, owing to their chronicity, represent a significant cost to healthcare. Key elements in the success of controlling these entities have been the development of potent and safe drugs based on physiological targets. The histamine-2 receptor antagonists revolutionized the treatment of acid peptic disorders owing to their safety and efficacy profile. The proton-pump inhibitors (PPIs) represent a further therapeutic advance due to more potent inhibition of acid secretion. Ample data from clinical trials and observational experience have confirmed the utility of these agents in the treatment of acid peptic diseases, with differential efficacy and safety characteristics between and within drug classes. Paradigms in their speed and duration of action have underscored the need for new chemical entities that, from a single dose, would provide reliable duration of acid control, particularly at night. Moreover, PPIs reduce, but do not eliminate, the risk of ulcers in patients taking NSAIDs, reflecting untargeted physiopathologic pathways and a breach in the ability to sustain an intragastric pH of more than 4. This review provides an assessment of the current understanding of the physiology of acid production, a discussion of medications targeting gastric acid production and a review of efficacy in specific acid peptic diseases, as well as current challenges and future directions in the treatment of acid-mediated diseases.
Authors:
Alex Mejia; Walter K Kraft
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Expert review of clinical pharmacology     Volume:  2     ISSN:  1751-2441     ISO Abbreviation:  -     Publication Date:  2009 May 
Date Detail:
Created Date:  2011-8-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101278296     Medline TA:  Expert Rev Clin Pharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  295-314     Citation Subset:  -    
Affiliation:
Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, 1170 Main Building, 132 South 10th Street, Philadelphia, PA 19107-5244, USA, Tel.: +1 203 243 7501.
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
T32 GM008562-14//NIGMS NIH HHS

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