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Specialty professional organizations recommend that people take the lowest effective PPI dose to achieve the desired therapeutic result when used to treat gastroesophageal reflux disease long-term. [ 20 ] [ 21 ] [ 22 ] In the United States, the Food and Drug Administration (FDA) has advised that over-the-counter PPIs, such as Prilosec OTC ...
Pantoprazole was first prepared in April 1985 by a small group of scale-up chemists. It is a dimethoxy-substituted pyridine bound to a fluoroalkoxy substituted benzimidazole. [5] Pantoprazole sodium is available as gastroresistant or delayed release tablets and as lyophilized powder for intravenous use.
Esomeprazole, sold under the brand name Nexium [or Neksium] among others, [2] is a medication which reduces stomach acid. [11] It is used to treat gastroesophageal reflux disease , peptic ulcer disease , and Zollinger–Ellison syndrome .
Pantoprazole, sold under the brand name Protonix, among others, is a medication used for the treatment of stomach ulcers, short-term treatment of erosive esophagitis due to gastroesophageal reflux disease (GERD), maintenance of healing of erosive esophagitis, and pathological hypersecretory conditions including Zollinger–Ellison syndrome.
As of 2006, a standard triple therapy is amoxicillin, clarithromycin, and a proton pump inhibitor such as omeprazole, [15] lansoprazole, pantoprazole, or esomeprazole. Protocols with metronidazole were also in use. [15] An example of a fixed-dose combination is PantoPac, containing pantoprazole, clarithromycin, and amoxicillin. [citation needed]
AstraZeneca also developed esomeprazole (Nexium) which is a eutomer, purely the (S)-enantiomer, rather than a racemate like omeprazole. [ medical citation needed ] Omeprazole undergoes a chiral shift in vivo which converts the inactive ( R )-enantiomer to the active ( S )-enantiomer, doubling the concentration of the active form. [ 59 ]
In some cases, a person with GERD symptoms can manage them by taking over-the-counter drugs. [50] [51] [52] This is often safer and less expensive than taking prescription drugs. [50] Some guidelines recommend trying to treat symptoms with an H 2 antagonist before using a proton-pump inhibitor because of cost and safety concerns. [50]
[1] [2] The GI cocktail is commonly prescribed in the hospital or emergency department, and has been used to help distinguish chest pain as either gastrointestinal or cardiac. [1] While it has been widely used in the treatment of dyspepsia, studies have suggested that the GI cocktail is only as effective as antacids alone.
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