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Drugs and Therapeutics
Published in James Sherifi, General Practice Under the NHS, 2023
Concerns, thankfully unfounded, were raised that unbridled suppression of gastric acid for lengthy periods could lead to stomach cancer. Although this debate is ongoing,20,21,22 these fears have not led to any noticeable reduction in the prescribing of these compounds. Omeprazole—1979Gastro-Oesophageal Reflux Disease, Peptic Ulcer Omeprazole (marketed in 1989 by Astra AB, now AstraZeneca) and the proton pump inhibitors, PPI, built on pre-existing target-driven drug innovation. Whilst undoubtedly more effective at suppressing gastric acid and arguably having a lower side-effect profile, their main benefit over the H2 antagonists was compliance, a once-daily dosage. Despite this marginal benefit, omeprazole soon became the number one prescribed drug worldwide, a position it held for many years, establishing its parent company, Astra AB, as a global player.
Nutritional and Dietary Supplementation during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Omeprazole (Prilosec) is a proton pump inhibitor (PPI). PPIs block the production of gastric acid. Among 295 infants whose mothers were exposed to omeprazole during embryogenesis, the frequency of congenital anomalies was no greater than among controls (Kallen, 1998). Additional information from the Swedish Registry reported 9607 infants exposed to omeprazole during the first trimester, among whom the frequency of birth defects was not significantly increased (Kallen, 2019). Ninety-one infants were born to women who took omeprazole during the first trimester and the frequency of congenital anomalies was no greater than expected (Lalkin et al., 1998). Among 233 infants exposed during the first trimester to omeprazole, the frequency of congenital anomalies was not significantly greater than unexposed controls (Diav-Citrin et al., 2005). A case report of an omeprazole overdose during pregnancy that resulted in a normal infant has been published (Ferner and Allison, 1993). A small case series (n = 3) in which mothers were treated with omeprazole chronically, resulted in three healthy infants in the neonatal period (Harper et al., 1995). No congenital anomalies were found among rat pups born to mothers given many times the usual human dose of omeprazole during embryogenesis, although growth retardation was present (Shimazu et al., 1988).
Gastrointestinal Diseases
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Anti-secretory therapy includes H2 blockers and PPIs. Example treatment regimens are150 mg ranitidine every 12 hours or 300 mg at bedtime until clinical improvement (or confirmed healing)20 mg omeprazole daily for 4–8 weeks.
Metabolomics approach of Symphyotrichum squamatum ethanol extract and its nano-Ag formulation protective effect on gastric ulcer via bio-chemical and pathological analyses
Published in Biomarkers, 2023
Heba A. Hassan, Iriny M. Ayoub, Tamer I. M. Ragab, Sherif M. Afifi, Abd El-Nasser G. El-Gendy, Abdel Razik H. Farrag, Ahmed M. Abd-ELGawad, Mohamed Farag, Abdelsamed Elshamy, Naglaa M. Ammar
Gastric ulcer (GU) is a benign lesion associated with an imbalance between gastric protective agents and aggressive physical, chemical, or psychological disorders on the mucosal epithelium, with multiple aetiologies (Mousa et al.2019). Smoking, stress, alcohol, extended administration of nonsteroidal anti-inflammatory medicines (NSAIDs), gastric acid hypersecretion, pepsin activity, gastric contractions, gastric mucosa ischaemia, and particularly infection by Helicobacter pylori bacteria can lead to gastric ulcers (Song et al.2019). The ethanol-induced gastric ulcer rodent model is commonly used to study acute gastritis (Cho and Ogle 1992). Ethanol disrupts the integrity of the gastrointestinal barrier by exfoliating cells and increasing mucosal permeability, which can lead to bleeding in some cases (Sofi et al.2020). Omeprazole which is used to treat gastric ulcers can be occasionally ineffective due to drug interaction or undesirable side effects. Identification of bioactive agents form plant extracts presented promising approach in the treatment of stomach ulcers, making them an appealing source of novel medications (Al-Wajeeh et al.2017).
Does omeprazole improve asthma-control in poorly-controlled asthmatic children with gastro-esophageal reflux
Published in Journal of Asthma, 2022
Abdelghani Yagoubi, Youcef Laid, Leila Smati, Keltoum Nafissa Benhalla, Fadila Benhassine
The main objective of our study was to evaluate the efficacy of PPI therapy on asthma control in children. We chose to use omeprazole because of its demonstrated superiority over antihistamine anti-secretory agents, its non-inferiority compared to other PPIs and its safety after many years of widespread use in humans. Improved asthma control after treatment of GERD would support a causal link between the two conditions. This aspect of association has been widely discussed in literature with conflicting results. Some authors concluded that there was a clinical or functional improvement (23,27,29,38), while some found no efficacy of anti-reflux treatment on the evolution of asthma (35,39,40). The analysis of these studies showed that the discrepancy of the results was again the consequence of methodological insufficiencies in relation to a short sample size, the absence of a control group in some studies, the absence of randomization in others, the absence of objective evaluation of acidity suppression after anti-reflux treatment or the short duration of anti-reflux treatment (5,6). After taking into account numerous methodological shortcomings, we were able to show that treatment with PPIs for 6 months of GERD proven by 24-h pH-metry in children with poorly controlled asthma improved asthma control in 5 out of 6 (84.9%) children in a significant way.
Population pharmacokinetics of omeprazole in obese and normal-weight adults
Published in Expert Review of Clinical Pharmacology, 2022
Kaifeng Chen, Ping Luo, Guoping Yang, Shaihong Zhu, Chenhui Deng, Junjie Ding, Yaqi Lin, Liyong Zhu, Qi Pei
Omeprazole, a first-generation proton pump inhibitor (PPI), is extensively used to treat acid-related diseases and is available both as prescription and over-the-counter medications [5]. To prevent the early degradation of this drug in the stomach, oral dosage forms of omeprazole are usually formulated as enteric-coated preparations [6], such as enteric-coated capsules. Currently, the PK data of omeprazole in obese patients are still limited, and the approved dosage of omeprazole is the same for normal-weight and obese individuals [7]. Inadequate exposure may lead to treatment failure as determined by the area under the concentration-time curve (AUC), and overexposure may be related to adverse events [8–10], such as osteoporosis-related fractures, interstitial nephritis and gastrointestinal infections, particularly with long-term PPI treatment [8,11,12]. Hence, gaining insight into the PK profile of omeprazole in obese patients is of the utmost importance to determine whether dose adjustment is required.