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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.
Senast uppdaterad: 2014-04-24
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apa ini masih ada
这个还有吗
Senast uppdaterad: 2022-02-19
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selama persediaan masih ada
applies multiply
Senast uppdaterad: 2019-04-18
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selama stock masih ada.
while stock is still in stock
Senast uppdaterad: 2024-06-09
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berlaku selama persediaan masih ada
while supplies last
Senast uppdaterad: 2019-04-12
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masih ada syarat yang harus dilengkapi
there are still obstacles
Senast uppdaterad: 2012-04-22
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dia menjawab: "masih ada tambahan?"
it will say, "are there any more (to come)?"
Senast uppdaterad: 2014-07-03
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Varning: Innehåller osynlig HTML-formatering
masih berada di episode menunggu
masih berada di episode menunggu
Senast uppdaterad: 2024-01-26
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biarlah kita merendahkan diri dan menyerah, karena mungkin harapan masih ada
he putteth his mouth in the dust; if so be there may be hope.
Senast uppdaterad: 2012-05-06
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dengarkanlah sebentar lagi, dan bersabarlah, masih ada yang hendak kukatakan demi allah
elihu also proceeded, and said,
Senast uppdaterad: 2012-05-06
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wabah virus covid 19 masih ada saat ini, covid 19 awalnya berasal dari china
the covid 19 virus outbreak still exists today, covid 19 originally came from china
Senast uppdaterad: 2022-03-23
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nama saya adalah saya sendiri
my name is myself
Senast uppdaterad: 2021-08-30
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daerah crystal creek, sis barat black range semakin parah - mengungsi sekarang, selama masih ada kesempatan
strictly, a writer and web publisher living in brisbane, provided a lot of information.
Senast uppdaterad: 2016-02-24
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terima kasih telah mengerti keadaan saya
thank you for understanding my situation.
Senast uppdaterad: 2023-09-06
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saya memiliki nenek. hussband nya adalah saya
i have a grandmother. her hussband is my
Senast uppdaterad: 2016-03-21
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hal berkesan saya selama liburan kemarin itu adalah saya mendapatkan banyak waktu bersama keluarga saya, walaupun saya dan keluarga tidak pergi berlibur
my memorable thing during the holidays was that i got a lot of time with my family, even though my family and i didn't go on vacation
Senast uppdaterad: 2024-01-03
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terima kasih telah menginformasikan kami waktu kedatangan anda. dengan senang hati, anda bisa melakukan check in pada pukul 11.30. jika ada pertanyaan lebih lanjut. jangan sungkan untuk bertanya kepada kami
Senast uppdaterad: 2024-05-08
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