In daily life, many people experience symptoms of stomach upset, such as stomach pain, acid reflux, and heartburn. 60-year-old Uncle Wang suffered from this problem, and was diagnosed with a stomach ulcer by a doctor, and was significantly relieved by taking omeprazole. However, when his wife had similar symptoms, he was advised to choose pantoprazole due to his concomitant cardiovascular disease and long-term use of clopidogrel tablets. Today, we will analyze in detail the commonly used lazole drugs in clinical practice and their differences.
1. Lazole drugs, the full name of proton pump inhibitors (PPIs), is the first-line drug for the treatment of gastrointestinal mucosal injury diseases. At present, there are five common clinical types, including the first-generation omeprazole, lansoprazole and pantoprazole, and the second-generation rabeprazole and esomeprazole.
In terms of mechanism of action, PPI mainly inhibits the last step of gastric acid secretion by blocking the H+-K+-ATPase (i.e., proton pump) function on gastric parietal cells, so as to achieve a strong and long-lasting effect of reducing gastric acid secretion. This is essential for the treatment of conditions such as gastric and duodenal ulcers, chronic gastritis, reflux esophagitis, and even Zör-Ellison syndrome caused by excess stomach acid. At the same time, lazoles are also one of the standard protocols for eradicating H. pylori infection.
2. Types and differences of PPI
At present, there are many commonly used PPIs in clinical practice, mainly including first-generation PPIs (such as omeprazole, lansoprazole, pantoprazole) and second-generation PPIs (such as rabeprazole, esomeprazole). These PPIs have certain differences in acid suppression strength, speed of onset, and duration.
First-generation PPIs: omeprazole, lansoprazole, and pantoprazole, as first-generation PPIs, have been used in clinical practice for many years, and their efficacy has been widely recognized. They mainly reduce gastric acid secretion by inhibiting the activity of proton pumps, thereby relieving symptoms such as stomach pain, acid reflux, etc.
Second-generation PPIs: Rabeprazole and esomeprazole, as second-generation PPIs, perform better than first-generation PPIs in terms of acid inhibition strength, onset of action, and duration. Therefore, when treating diseases of the gastrointestinal mucosa, doctors often give preference to the use of second-generation PPIs.
3. Clinical application of PPI
PPI is mainly used to treat or prevent gastrointestinal mucosal damage diseases caused by excessive gastric acid secretion, such as gastric and duodenal ulcers, chronic gastritis, reflux esophagitis, Zol-Erison syndrome, etc. In addition, PPIs are commonly used in the eradication treatment of Helicobacter pylori. By combining with antibiotics and other drugs, PPIs can effectively improve the eradication rate of Helicobacter pylori and reduce the risk of ulcer rebleeding.
In combination, PPIs are often used with nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), antiplatelet drugs (e.g., aspirin), or glucocorticoids (e.g., prednisone) to prevent ulcers and reduce the risk of bleeding. However, it should be noted that PPI has an inhibitory effect on liver drug enzyme CYP2C19, which may affect the metabolism of other drugs, resulting in high blood drug concentrations. For example, when combined with clopidogrel is required, pantoprazole or rabeprazole, which have less CYP2C19 inhibition, should be chosen to avoid attenuating the antiplatelet effect of clopidogrel.
For special populations, such as pediatric patients, omeprazole and lansoprazole have been shown to be relatively safe and can be used in kilograms of body weight, whereas several other PPIs are not supported by sufficient data for pediatric use. For pregnant and lactating women, according to the safety classification of drugs during pregnancy, lansoprazole, pantoprazole and rabeprazole are grade B and safer, while omeprazole and esoprazole are grade C and should be used with caution. In addition, all PPIs may be secreted with breast milk and should be used with caution by lactating women.
4. How to use PPI correctly
Take your medication as prescribed: When using PPIs, follow your doctor's advice and prescription and follow the prescribed dosage, dosage, and course of treatment. Do not increase or decrease the dose or change the way you take your medication.
Pay attention to the timing of administration: PPIs are usually best taken before meals. This is because taking it before a meal allows the drug to stay in the stomach longer, allowing it to work better against acid. However, the exact timing of medication depends on the doctor's advice and individual circumstances.
Pay attention to adverse reactions: In the process of using PPI, if there are adverse reactions such as headache, diarrhea, nausea, etc., you should consult a doctor or pharmacist in time. If symptoms are severe or persistent, seek medical attention promptly.
Avoid interactions with other drugs: When using PPIs, try to avoid concomitant use with other drugs to avoid drug interactions. If you need to use other drugs at the same time, you should consult your doctor or pharmacist about drug interactions and precautions.
Although proton pump inhibitors are effective in the short term, long-term use may bring some potential risks, in general, in the face of stomach discomfort, the right drug selection and reasonable medication strategy are essential to restore health, and also remind the majority of patients to pay close attention to their own reactions during the medication process and seek medical advice in time. #Rabeprazole##Lazole##Omeprazole#