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Cited by 127Gastroesophageal reflux and treatmentsHelicobacter pylori-related gastroenterology studiesGastrointestinal motility and disorders

The DOI matches its Crossref record; 93 of the 97 references it cites were found in a registry or an index.

Pharmacological and pharmacodynamic essentials of H2-receptor antagonists and proton pump inhibitors for the practising physician

Huang, Jia-Qing, Hunt, Richard H.·2001·Best Practice & Research Clinical Gastroenterology
DOI 10.1053/bega.2001.0184
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Abstract

The suppression of gastric acid secretion with anti-secretory agents has been the mainstay of medical treatment for patients with acid-related disorders. Although the majority of Helicobacter pylori -related peptic ulcers can be healed with antibiotics, ulcer healing and symptom control can be significantly improved when antibiotics are given with anti-secretory agents, especially with a proton pump inhibitor. There is a dynamic relationship between the suppression of intragastric acidity and the healing of peptic ulcer and erosive oesophagitis and control of acid-related symptoms. The suppression of gastric acid secretion achieved with H(2)-receptor antagonists has, however, proved to be suboptimal for effectively controlling acid-related disorders, especially for healing erosive oesophagitis and for the relief of reflux symptoms. H(2)-receptor antagonists are also not effective in inhibiting meal-stimulated acid secretion, which is required for managing patients with erosive oesophagitis. Furthermore, the rapid development of tolerance to H(2)-receptor antagonists and the rebound acid hypersecretion after the withdrawal of an H(2)-receptor antagonist further limit their clinical use. Although low-dose H(2)-receptor antagonists are currently available as over-the-counter medications for self-controlling acid-related symptoms, their pharmacology and pharmacodynamics have not been well studied, especially in the self-medicating population. Proton pump inhibitors have been proved to be very effective for suppressing intragastric acidity to all known stimuli, although variations exist in the rapidity of onset of action and the potency of acid inhibition after oral administration at the approved therapeutic doses, which may have important clinical implications for the treatment of gastro-oesophageal reflux disease and perhaps for eradicating H. pylori infection when a proton pump inhibitor is given with antibiotics. Once-daily dosing in the morning is more effective than dosing in the evening for all proton pump inhibitors with respect to the suppression of intragastric acidity and daytime gastric acid secretion in particular, which may result from a better bio-availability being achieved with the morning dose. When higher doses are needed, these drugs must be given twice daily to achieve the optimal suppression of 24 hour intragastric acidity. Preliminary results have shown that esomeprazole, the optical isomer of omeprazole, given at 40 mg, is significantly more effective than omeprazole 40 mg, lansoprazole 30 mg or pantoprazole 40 mg for suppressing gastric acid secretion. However, more studies in different patient populations are needed to compare esomeprazole with the existing proton pump inhibitors with regard to their efficacy, cost-effectiveness and long-term safety for the management of acid-related disorders.

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Crossref · 10.1053/bega.2001.0184

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93 of 93 references verified0 citation errors · 0 not checkable

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Show all 97 references

Research works printed but not linked: 5

  1. Wilde, 1994, Omeprazole: an update of its pharmacology and therapeutic use in acid-related disorders, Drug, 48, 91, 10.2165/00003495-199448010-00008 · DOI
  2. Langtry, 1997, Lansoprazole: an update of its pharmacological properties and clinical efficacy in the management of acid-related disorders, Drugs, 54, 473, 10.2165/00003495-199754030-00010 · DOI
  3. Sridhar, 1998, Dosing frequency to maximum effect of lansoprazole 30mg on 24-hour intragastric pH in normal volunteers, American Journal of Gastroenterology, 93, 1648
  4. Andersson, 1996, Pharmacokinetics, metabolism and interactions of acid pump inhibitors: focus on omeprazole, lansoprazole and pantoprazole, Clinical Pharmacokinetics, 31, 9, 10.2165/00003088-199631010-00002 · DOI
  5. Blanshard, 1996, The effects of rabeprazole on 24-hour intragastric acidity and plasma gastrin concentration in healthy subjects, Gut, 39

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Metadata

Authors
Huang, J.-Q., & Hunt, R. H.
Affiliations
McMaster University Medical Centre (CA)
ORCID
Hunt, Richard H.
Venue
Best Practice & Research Clinical Gastroenterology
Publisher
Elsevier BV
Published
2001-06
Volume
15
Issue
3
Pages
355-370
ISSN
1521-6918 (ISSN-L)
DOI
10.1053/bega.2001.0184
OpenAlex
W2075215328
Cited by
127
References
97
Citations by year
2026: 2 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 9 · 2018: 4 · 2017: 2 · 2016: 9 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 5
FWCI
1.48
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Best Practice & Research Clinical Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
  • Health Sciences › Medicine › Gastroenterology › Helicobacter pylori-related gastroenterology studies
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
H2 receptor antagonists, proton pump inhibitors, gastric acid secretion, acid-related diseases, gastroesophageal reflux disease, erosive esophagitis, peptic ulcer, Helicobacter pylori eradication, omeprazole, esomeprazole, lansoprazole, pantoprazole, drug tolerance
MeSH terms
Anti-Ulcer Agents, Drug Therapy, Combination, Gastric Acid, Gastroesophageal Reflux, Histamine H2 Antagonists, Humans, Peptic Ulcer, Proton Pumps, Proton Pump Inhibitors

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