Drugs online research references
Pharm Res. 2001 May;18(5):615-21.
CYP2C19 genotype related effect of omeprazole on intragastric pH and antimicrobial stability.
Kita T, Tanigawara Y, Aoyama N, Hohda T, Saijoh Y, Komada F, Sakaeda T, Okumura K, Sakai T, Kasuga M.
Department of Hospital Pharmacy, School of Medicine, Kobe University, Japan.
PURPOSE: A combination of proton pump inhibitors and antimicrobials has been applied as an anti-Helicobacter pylori (H. pylori) therapy. Omeprazole, one of the proton pump inhibitors, is metabolized by CYP2C19. which exhibits genetic polymorphism. It was reported previously that the overall anti-H. pylori efficacy can be related to the CYP2C19 genotype. The main aim of the present study was to obtain a rational explanation for the relationship between the overall anti-H. pylori efficacy and the CYP2C19 genotype. METHODS: Six healthy volunteers were classified as extensive metabolizers and poor metabolizers, according to their CYP2C19 genotypes. Plasma concentrations and intragastric pH were monitored prior to and until 24 h after the administration of 20 mg omeprazole. The stability of amoxicillin, clarithromycin, and metronidazole was examined using buffer solutions with monitored intragastric pH, and their remaining percentage in the intragastric space was simulated. RESULTS: The poor metabolizers, classified by the CYP2C19 genotypes, showed the higher effectiveness in anti-H. pylori therapy, via the higher plasma concentration of omeprazole and the higher intragastric pH, and possibly the higher stability of antimicrobials in the higher intragastric pH. CONCLUSIONS: CYP2C19 genotyping is a very useful method to determine the effective and safe dosage regimen including the selection of the dual and triple therapy in anti-H. pylori therapy.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11465416&dopt=Abstract
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Pharm World Sci. 2001 Jun;23(3):107-10.
Factors associated with non-response in proton pump inhibitor users: a study of lansoprazole therapy.
Claessens AA, Heerdink ER, Lamers CB, van Eijk JT, Leufkens HG.
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht, The Netherlands.
BACKGROUND: Proton pump inhibitors (PPI) demonstrate high healing rates of 85-98% in clinical trials. Due to the limited knowledge regarding response and non-response to lansoprazole in daily practice and for the reason that resistance to PPIs is scarce, we investigated factors possibly associated with non-response. METHODS: Data were used from a prospective, open label, observational follow-up study in which 10,008 lansoprazole users were followed over time. The study was designed according to the SAMM guidelines. A matched nested case-control design was used to compare non-responding (cases) and responding (controls) lansoprazole users. Non-response was defined as worsening or non-improvement of symptoms at the first evaluation after at least 8 weeks of use, response as disappearance or improvement of symptoms within 8 weeks of use. Controls were matched for the evaluating physician. RESULTS: A total of 186 non-responders and 372 responders to PPI treatment were identified as cases and controls. Age of over 60 years, heavy smoking and previous use of PPIs were significantly more common in non-responding patients compared with responding patients. There were no differences found between the reported diagnosis regarding response. CONCLUSION: In daily clinical practice, previous use of PPIs, heavy smoking and an age > 60 years were significantly associated with non-response to treatment with lansoprazole. Previous use of PPIs in non-responding patients might suggest resistance to PPIs. The knowledge that non-response drives non-response may encourage physicians to follow PPI users with previous PPI use more closely.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11468874&dopt=Abstract
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J Int Med Res. 2001 May-Jun;29(3):178-80.
Effects of eradication therapy on gastric emptying in patients with Helicobacter pylori-positive duodenal ulcers.
Onuk MD, Uslu H, Varoglu E.
Gastroenterology Department, Ataturk University Medical Faculty, Erzurum, Turkey.
In this study 28 patients with Helicobacter pylori-positive duodenal ulcers were treated with a 7-day triple-therapy regimen (omeprazole, clarithromycin, amoxycillin). Gastric emptying time was measured scintigraphically before and after therapy. Only 13 patients attended regularly for their endoscopic and scintigraphic follow-ups. Gastric emptying time was 57.6+/-16.5 min in 28 patients before therapy, and 44.4+/-13.9 min after therapy (44.7+/-7.9 min in the control group). The present study demonstrated gastric emptying time to be longer in the ulcer patients compared with healthy controls and that, after eradication therapy, gastric emptying time became almost normal in the ulcer patients.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11471854&dopt=Abstract
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