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Proton-pump inhibitors have largely superseded the H 2-receptor antagonists, a group of medications with similar effects but a different mode of action, and heavy use of antacids. [3] A potassium-competitive acid blocker (PCAB) revaprazan was marketed in Korea as an alternative to a PPI.
A blood test including platelets and a clotting screen should be performed prior to administration of anticoagulant regimens in pregnancy. [ 13 ] Subcutaneous tinzaparin may be given at doses of 175 units of antifactor Xa activity per kg, [ 13 ] based on prepregnancy or booking weight at approximately 16 weeks, and not the current weight. [ 13 ]
A derivative of timoprazole, omeprazole, was discovered in 1979, and was the first of a new class of drug that control acid secretion in the stomach, a proton pump inhibitor (PPI). [ 11 ] [ 12 ] Addition of 5-methoxy-substitution to the benzimidazole moiety of omeprazole was also made and gave the compound much more stability at neutral pH. [ 6 ]
Use in pregnancy appears to be safe. [5] Pantoprazole is a proton pump inhibitor that decreases gastric acid secretion. [5] It works by inactivating (H+/K+)-ATPase function in the stomach. [9] [5] The study of pantoprazole began in 1985, and it came into medical use in Germany in 1994. [10] It is available as a generic medication.
Use in pregnancy and breastfeeding is of unclear safety. [5] It works by blocking H + /K +-ATPase in the parietal cells of the stomach. [3] Dexlansoprazole was approved for medical use in the United States in 2009. [3] In Canada in 2016, it was the most expensive Proton-pump inhibitor (PPI) available. [4]
Lansoprazole, sold under the brand name Prevacid among others, is a medication which reduces stomach acid. [4] It is a proton pump inhibitor (PPI), used to treat peptic ulcer disease, gastroesophageal reflux disease, and Zollinger–Ellison syndrome. [5] Its effectiveness is similar to that of other PPIs. [6] It is taken by mouth. [4]
Ball-and-stick model of cimetidine, the prototypical H 2 receptor antagonist. H 2 antagonists, sometimes referred to as H2RAs [1] and also called H 2 blockers, are a class of medications that block the action of histamine at the histamine H 2 receptors of the parietal cells in the stomach. This decreases the production of stomach acid.
[31] [32] In any subsequent pregnancy, careful monitoring is necessary. A stress test or echocardiogram should be complete prior to a subsequent pregnancy. Where relapse occurs, conventional treatment should be resumed, including hydralazine with nitrates plus beta-blockers during pregnancy, or ACE-inhibitors plus beta-blockers following pregnancy.