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kamu lebih muda dari saya
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Laatste Update: 2014-12-29
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
masih ada yang ditutupi dari saya
the most potent suppressors of gastric acid secretion are inhibitors of the gastric h+,k+-atpase (proton pump) (figure 36–2a). in typical doses, these drugs diminish the daily production of acid (basal and stimulated) by 80% to 95%. five proton pump inhibitors are available for clinical use: omeprazole (prilosec, rapinex, zegerid) and its s-isomer, esomeprazole (nexium), lansoprazole (prevacid), rabeprazole (aciphex), and pantoprazole (protonix). these drugs have different substitutions on their pyridine and/or benzimidazole groups but are remarkably similar in their pharmacological properties (see appendix ii). omeprazole is a racemic mixture of r- and s-isomers; the s-isomer, esomeprazole (s-omeprazole), is eliminated less rapidly than r-omeprazole, which theoretically provides a therapeutic advantage because of the increased half-life. despite claims to the contrary, all proton pump inhibitors have equivalent efficacy at comparable doses. proton pump inhibitors are prodrugs that require activation in an acid environment. after absorption into the systemic circulation, the prodrug diffuses into the parietal cells of the stomach and accumulates in the acidic secretory canaliculi. here, it is activated by proton-catalyzed formation of a tetracyclic sulfenamide (figure 36–2), trapping the drug so that it cannot diffuse back across the canalicular membrane. the activated form then binds covalently with sulfhydryl groups of cysteines in the h+,k+-atpase, irreversibly inactivating the pump molecule. acid secretion resumes only after new pump molecules are synthesized and inserted into the luminal membrane, providing a prolonged (up to 24- to 48-hour) suppression of acid secretion, despite the much shorter plasma half-lives (0.5 to 2 hours) of the parent compounds. because they block the final step in acid production, the proton pump inhibitors are effective in acid suppression regardless of other stimulating factors. the most potent suppressors of gastric acid secretion are inhibitors of the gastric h+,k+-atpase (proton pump) (figure 36–2a). in typical doses, these drugs diminish the daily production of acid (basal and stimulated) by 80% to 95%. five proton pump inhibitors are available for clinical use: omeprazole (prilosec, rapinex, zegerid) and its s-isomer, esomeprazole (nexium), lansoprazole (prevacid), rabeprazole (aciphex), and pantoprazole (protonix). these drugs have different substitutions on their pyridine and/or benzimidazole groups but are remarkably similar in their pharmacological properties (see appendix ii). omeprazole is a racemic mixture of r- and s-isomers; the s-isomer, esomeprazole (s-omeprazole), is eliminated less rapidly than r-omeprazole, which theoretically provides a therapeutic advantage because of the increased half-life. despite claims to the contrary, all proton pump inhibitors have equivalent efficacy at comparable doses. proton pump inhibitors are prodrugs that require activation in an acid environment. after absorption into the systemic circulation, the prodrug diffuses into the parietal cells of the stomach and accumulates in the acidic secretory canaliculi. here, it is activated by proton-catalyzed formation of a tetracyclic sulfenamide (figure 36–2), trapping the drug so that it cannot diffuse back across the canalicular membrane. the activated form then binds covalently with sulfhydryl groups of cysteines in the h+,k+-atpase, irreversibly inactivating the pump molecule. acid secretion resumes only after new pump molecules are synthesized and inserted into the luminal membrane, providing a prolonged (up to 24- to 48-hour) suppression of acid secretion, despite the much shorter plasma half-lives (0.5 to 2 hours) of the parent compounds. because they block the final step in acid production, the proton pump inhibitors are effective in acid suppression regardless of other stimulating factors.
Laatste Update: 2014-04-24
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
umurnya jauh lebih tua
so different from our age
Laatste Update: 2020-11-10
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
menawarkan pekerjaan yang lebih baik
better job offer
Laatste Update: 2023-04-13
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
sekian dari saya
that's all from me
Laatste Update: 2023-09-13
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
peluk jauh dari saya
hug away from me
Laatste Update: 2024-04-14
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
cukup sekian penjelasan dari saya
enough of my explanation
Laatste Update: 2020-08-27
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
di hari raya yg lebih tua harus memberikan uang ke yang lebih muda
Laatste Update: 2024-04-10
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
sekian dari saya,saya akhiri wassalam
from the psp b class, here
Laatste Update: 2020-12-10
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
cukup sekian dari saya dan terima kasih
that's all and thank you
Laatste Update: 2020-11-01
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
apa jawaban dari saya akan selalu mencintaimu selamanya
apa jawaban dari i will always love you forever
Laatste Update: 2018-05-02
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
saya anak ke 2 dari 2 bersaudara, kaka saya 8 tahun lebih tua dari saya sekarang berusia 28 tahun, kaka saya bekerja sebagai pegawai bank dari tahun 2014
i am the 2nd child of 2 siblings, my brother is 8 years older than i am now 28 years old, my brother worked as a bank employee from 2014
Laatste Update: 2020-09-17
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
di mulai dari saya bangun sampai saya tidur kembali
i pray maghrib and isha prayer
Laatste Update: 2023-09-28
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
sekian cerita dari saya dan terimakasih telah mendengarkan cerita saya ini.
that's my story and thank you for listening to my story.
Laatste Update: 2022-05-11
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
karna bercanda yang berlebihan
i learned silence from talking a lot
Laatste Update: 2021-10-26
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
sombong sekali anda! sampai tidak sempat membalas pesan singkat dari saya:'(
arrogant once you! until it didn't get reply short message from me: ' (
Laatste Update: 2018-11-12
Gebruiksfrequentie: 1
Kwaliteit:
Referentie:
kepada bela saya mengundang anda ke acara ulangtahun saya , saya harap anda datang ke acara saya , salam dari saya nanda permata sari
dear friends, i invite you to my birthday party, i hope you come to my event, greet me nanda gem sari
Laatste Update: 2023-03-16
Gebruiksfrequentie: 1
Kwaliteit:
Referentie: