Clinical Perspectives of Drugs Inhibiting Acid Secretion-H⁺K⁺-ATPase Inhibitors

Abstract

The H K -ATPase is supposed to be the terminal step in the acid-secreting pathvvav in the parietal cell. Omeprazole blocks this enzyme, resulting in a marked inhibition of basal and stimulated acid secretion. With omeprazole 20 mg daily. 24-hour intragastric acidity is decreased by about 907c Several clinical studies have now been published in which omeprazole has been compared with the H.-receptor antagonists cimctidine and ranitidine. Omeprazole in doses between 20 and 40 mg daily resulted in healing rates between 659r and 82^r/r after treatment for 2 weeks and between 90^f 'r and 100'V after treatment for 4 weeks. Treatment with omeprazole also gave faster and more pronounced pain relief. One comparative study in gastric ulcer has also been published showing healing rates equal to those with ranitidine. Placebo-controlled trials have also shown very pronounced therapeutic effect in reflux esophagitis. Omeprazole seems to be the drug of choice in Zollinger-Ellison syndrome, giving beneficial clinical effects and pronounced and long-lasting reduction in gastric acid secretion.

Key Words:

• Duodenal ulcer
• gastric ulcer
• H′K′-ATPase inhibitors
• omeprazole
• reflux oesophagitis
• ZES