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2018, Number 2

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Rev Med MD 2018; 9.10 (2)

Antisecretory drug evolution: pharmacology and clinical uses

Lazcano-Becerra M, Velarde-Ruiz VJA, Aldana-Ledesma JM, Gómez-Castaños PC, Díaz-Aceves PE, García-Jiménez ES

Language: Spanish
References: 61
Page: 174-184
PDF size: 668.97 Kb.


ABSTRACT

Antisecretory drugs have been a historic medical need; hence, the first antisecretory drugs (antimuscarinic) were available in the 1950´s. But it was until the 1970´s that cimetidine, the first histamine antagonist, was launched. This marked a watershed in the history of acid peptic disease treatment. Afterwards, ranitidine was discovered in the 1980´s and it became one of the most sold drugs by 1988.
Proton pump inhibitors (PPIs) are nowadays one of the most prescribed drugs and are sold without any medical prescription, becoming one of most worldwide consumed drugs. Omeprazol was the first PPI to be commercialized in 1989, followed by lanzoprazol, rabeprazol, pantoprazole, esomeprazole and dexlanzoprazol. Their effectivity to reduce acid secretion has been associated to adverse effects like osteoporosis, iron and vitamin B12 absorption abnormalities, hypomagnesemia, acute and chronic kidney disease, dementia, acute myocardial infraction, Clostridium Difficile infection, among others. Despite this, most of them have little supporting evidence and they have only been reported in observational studies. PPIs must be used only for precise medical indications and the least minimal effective dose must be prescribed for the shortest time, in order to limit prolonged exposition and adverse effects. This review is focused on historical events, clinical uses, adverse and transcendental effects with antisecretory drugs, as well as their future.


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