Proton pump inhibitors in GORDAn overview of their pharmacology, efficacy and safety

Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all?

“…Histamine activates adenylyl cyclase which increases intracellular cyclic adenosine monophosphate (cAMP) concentrations. The intracellular cAMP activates protein kinases which then activate the H + /K + -ATPase pump [13][14][15] . Despite the different actions of each of the neurohormones, the final converging step towards gastric acid production is through the activation of the H + /K + -ATPase pump [16] .…”

“…Despite the different actions of each of the neurohormones, the final converging step towards gastric acid production is through the activation of the H + /K + -ATPase pump [16] . The H + /K + -ATPase pump releases hydrogen ions into the gastric lumen in exchange for potassium ions [13,15] . These pumps generate a pH of 0.8 to 1.0 within the parietal cell [15] .…”

“…The H + /K + -ATPase pump releases hydrogen ions into the gastric lumen in exchange for potassium ions [13,15] . These pumps generate a pH of 0.8 to 1.0 within the parietal cell [15] . As a result, the parietal cell is the only membrane-enclosed space within the human body that achieves a pH below 4.0 [14] .…”

“…However, a gastric pH above 4 is recommended to effectively treat GERD, PUD and H pylori infections [13] . With a single daily administration, PPIs can maintain an intragastric pH above 4 for 10.5 h to 16.8 h in a 24-h period [15,19] . The median 24-hour intragastric pH can vary from 3.6 to 4.9, depending on the particular PPI and milligram dose administered.…”

Esophageal impedance baselines in infants before and after placebo and proton pump inhibitor therapy

“…PPI therapy is proven effective for healing esophagitis in adults (13)(14)(15), for reducing acid exposure in infants (16)(17)(18) and is suggested to heal erosive esophagitis in 89% of children (19). However PPIs have not been proven to relieve symptoms of GERD in infants (20)(21)(22).…”