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Proton-pump inhibitors have largely superseded the H 2-receptor antagonists, a group of medications with similar effects but a different mode of action, and heavy use of antacids.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 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]
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.
Lansoprazole is used for treatment of: [3] Ulcers of the stomach and duodenum, and NSAID-induced ulcers; Helicobacter pylori infection, alongside antibiotics (adjunctive treatment), treatment to kill H. pylori causing ulcers or other problems involves using two other drugs besides lansoprazole known as "triple therapy", and involves taking twice daily for 10 or 14 days lansoprazole ...
Sucralfate may be considered to have the advantage over H2-blockers and PPIs in this regard because sucralfate does not change the pH of gastric fluid. A majority of meta-analyses found that sucralfate therapy decreased the incidence of ventilator-associated pneumonia compared to H2-antagonists. [10]
[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.