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Target Concepts:
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Query: UMLS:C0847097 (
acidity
)
15,165
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Proton pump inhibitors (PPIs) are used widely in the management of acid-related disorders and, for the majority of patients, oral therapy is highly effective. Not all patients with acid-related disorders respond completely to standard, once-daily PPI therapy, but most nonresponders will generally respond to an increase in the dose or frequency of PPI therapy. At equivalent doses, oral and intravenous (IV) PPIs produce comparable acid suppression; thus there are very few clinical indications for IV PPI therapy. IV PPIs are an appropriate substitute for oral PPIs, at an equivalent dose, for patients with, for example, gastroesophageal reflux disease, peptic ulceration, or
Zollinger-Ellison syndrome
, who cannot take oral medication. For patients with nonvariceal, upper gastrointestinal hemorrhage, profound acid suppression (gastric pH . 6.0) optimizes clot stability and reduces the risk of rebleeding; this is achieved most effectively with an initial IV PPI bolus followed by a continuous infusion. High-dose, IV PPI therapy is beneficial and cost-effective in patients who have a high-risk lesion at endoscopy and it should be preceded by effective endoscopic hemostasis if possible. IV PPIs, preoperatively and in the intensive care setting, effectively reduce gastric
acidity
, but there are no convincing data that this confers any significant clinical benefit compared with other therapeutic strategies.
...
PMID:Intravenous proton pump inhibitor therapy: a rationale for use. 1636 24
The first histamine H
2
receptor antagonists (H
2
RAs) were developed in the early 1970s. They played a dominant role in treating peptic ulcer disease and gastroesophageal reflux disease (GERD). H
2
RAs block the production of acid by H
+
, K
+
-ATPase at the parietal cells and produce gastric luminal anacidity for varying periods. H
2
RAs are highly selective, and they do not affect H1 receptors. Moreover, they are not anticholinergic agents. Sequential development of H
2
RAs, proton pump inhibitors (PPIs), and discovery of
Helicobacter pylori
infection changed the paradigm of peptic ulcer disease with marked decrease of morbidity and mortality. PPIs are known to be the most effective drugs that are currently available for suppressing gastric acid secretion. Many studies have shown its superiority over H
2
RAs as a treatment for acid-related disorders, such as peptic ulcer disease, GERD, and
Zollinger-Ellison syndrome
. However, other studies have reported that PPIs may not be able to render stomach achlorhydric and have identified a phenomenon of increasing gastric
acidity
at night in individuals receiving a PPI twice daily. These nocturnal acid breakthrough episodes can be eliminated with an addition of H
2
RAs at night. The effectiveness of nighttime dose of H
2
RA suggests a major role of histamine in nocturnal acid secretion. H
2
RAs reduce secretion of gastric acid, and each H
2
RA also has specific effects. For instance, nizitidine alleviates not only symptoms of GERD, but also provokes gastric emptying, resulting in clinical symptom improvement of functional dyspepsia. The aim of this paper was to review the characteristics and role of H
2
RAs and assess the future strategy and treatment of upper gastrointestinal disease, including acid related disorders.
...
PMID:The Effect of H
2
Receptor Antagonist in Acid Inhibition and Its Clinical Efficacy. 2872 10
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