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Proton pump inhibitors (PPIs) are the most potent drugs to inhibit gastric acid secretion, being used in the treatment of most inflammatory conditions of the gastric mucosa. They are among the most prescribed and overprescribed medications worldwide; for example, in the United States, according to the National Health and Nutrition Examination Survey, they almost doubled their use in adults aged 40 years and older from 4.9 % to 8.3 % between 1999 and 2012. Although they are generally considered well tolerated, some epidemiological studies extracting information from large databases have reported a number of adverse effects associated with their prolonged use, including cognitive impairment, chronic kidney disease, myocardial infarction, stroke, bone fractures and even death, among others. The objective was to conduct a narrative review of the literature on the effects of chronic use of PPIs on cognitive impairment in older adults. Articles were reviewed based on a search in the PubMed, Scopus and SciELO databases using both English and Spanish keywords and related MeSH/DeCS terms. Neurological side effects induced by chronic PPI use may be indirectly related to secondary systemic disorders (magnesium and vitamin B12 deficiency) or to direct effects on neuronal functioning after passing through the blood-brain barrier. Although several neurobiological mechanisms by which PPIs could favor the development of dementia--which involve Tau protein function, beta-amyloid [ßA] accumulation and cobalamin deficiency, among others--have been described, most of the available clinical evidence has not shown a significant association between PPI use and the risk of dementia or cognitive impairment. To establish the adverse clinical effects of chronic PPI use more clearly, especially on brain functioning, well-designed cohort studies with large sample sizes and long follow-up periods, with a reliable method to adjust for standardized confounders, as well as subgroup analyses are needed. [ABSTRACT FROM AUTHOR]

Los inhibidores de la bomba de protones (IBP) son los medicamentos más potentes para inhibir la secreción gástrica ácida, y se utilizan en el tratamiento de la mayor parte de las afecciones inflamatorias de la mucosa gástrica. Forman parte de los fármacos más recetados y sobreprescritos en todo el mundo; por ejemplo, en los Estados Unidos, según la Encuesta nacional de salud y nutrición, casi duplicaron su uso en los adultos de 40 años de un 4,9 % hasta un 8,3 %, entre los años 1999 a 2012. Aunque, en general, se consideran bien tolerados, algunos estudios epidemiológicos ―que extraen información a partir de grandes bases de datos― han reportado una serie de efectos adversos asociados con su uso prolongado, entre los cuales están el deterioro cognitivo, la enfermedad renal crónica, el infarto de miocardio, el accidente cerebrovascular, las fracturas óseas e incluso la muerte, entre otros. El objetivo fue realizar una revisión narrativa de la literatura acerca de los efectos del uso crónico de los IBP sobre el deterioro cognitivo en los adultos mayores. Se revisaron artículos a partir de una búsqueda en las bases de datos Pudmed, Scopus y Scielo con las palabras clave y términos Mesh/DeCS relacionados tanto en inglés como en español. Los efectos secundarios a nivel neurológico inducidos por el uso crónico de los IBP pueden estar relacionados indirectamente con la presencia de alteraciones sistémicas secundarias (deficiencia de magnesio y vitamina B12) o con efectos directos sobre el funcionamiento neuronal después de pasar a través de la barrera hematoencefálica. Si bien se han descrito varios mecanismos neurobiológicos por medio de los cuales los IBP podrían favorecer el desarrollo de la demencia ―que comprenden el funcionamiento de la proteína tau, la acumulación de beta amiloide (βA) y la deficiencia de cobalamina, entre otros―, la mayor parte de la evidencia clínica disponible no ha encontrado una asociación significativa entre el uso de los IBP y el riesgo de demencia o el deterioro cognitivo. Para establecer de una manera más clara los efectos clínicos adversos del uso crónico de los IBP, en especial, en el funcionamiento cerebral, se necesitan estudios de cohorte bien diseñados, con tamaños de muestra grandes y periodos de seguimiento prolongados, con un método confiable para ajustar los factores de confusión estandarizados y, además, realizar análisis por subgrupos.

Los inhibidores de la bomba de protones (IBP) son un grupo de fármacos cuya función consiste en el bloqueo irreversible de la bomba de protones (H+/K+-adenosina trifosfatasa) situada en las células parietales del estómago, disminuyendo la secreción ácida de forma eficaz, obteniendo el efecto beneficioso esperado. Según datos epidemiológicos a nivel nacional e internacional su prescripción suele ser inadecuada en una gran proporción de la población. En Venezuela, en vista de la necesidad de estudios actualizados se evalúa a través de un estudio observacional prospectivo, descriptivo y corte transversal, la prescripción de IBP en pacientes adultos hospitalizados en el Centro Médico Docente La Trinidad, periodo agosto - octubre de 2023. Se revisaron 50 historias clínicas en pacientes con dicha prescripción que cumplían con los criterios de inclusión y se contó con una ficha de recolección de los datos pertinentes a dicha investigación. La prescripción de IBP fue inadecuada en el 80% de los pacientes y 20% fue adecuada, con predominio del género femenino en un 52%; el 28% de los pacientes fueron hospitalizados por el servicio de cirugía general. Omeprazol fue el medicamente con mayor prescripción en un 68% de las indicaciones, generalmente a dosis de 40 mg/día vía endovenosa. De 11 pacientes un 54,55% de ellos tomaban IBP previo como antiácido. Se concluye que existe una alta prevalencia de prescripción de IBP, asociada a una indicación inadecuada; de allí que la población debe usar dichos fármacos bajo las correctas indicaciones y evitar sus efectos adversos a largo plazo.

Copyright of Journal of Health Science Yuksek Ihtisas University / Yüksek İhtisas Üniversitesi Sağlık Bilimleri Dergisi is the property of Journal of Health Science Yuksek Ihtisas University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: Los medicamentos antiulcerosos son utilizados frecuentemente en pacientes hospitalizados, sin embargo, a menudo este uso no está indicado. Objetivo: Describir la frecuencia de prescripción e indicación de medicamentos para prevenir el sangrado gastrointestinal en pacientes hospitalizados. Materiales y métodos: Estudio de corte trasversal, descriptivo, prospectivo del servicio de Medicina Interna de la Sociedad de Cirugía de Bogotá- Hospital de San José de Bogotá, Colombia. Se excluyeron pacientes con diagnóstico de sangrado gastrointestinal o antecedente de alergia a los medicamentos antiulcerosos. Se recolectaron datos demográficos, así como fármacos prescritos. Se determinó si la indicación del fármaco era adecuada y se identificó el tipo de error de prescripción. Resultados: Se incluyeron 179 pacientes, 102 (57%) mujeres. Promedio de edad de 61,3 años (±20,2). El principal diagnóstico de ingreso fue enfermedad infecciosa 76 (42,4%). Del total de pacientes, 165 (92,17%) recibieron medicamento para prevención del sangrado gastrointestinal. La indicación fue adecuada en 75 pacientes (41,89%). El error más frecuente fue el uso en pacientes de bajo riesgo de sangrado, 101 (97,1%). Conclusión: Un alto porcentaje de los pacientes recibió medicación para la prevención del sangrado gastrointestinal. En aproximadamente la mitad de estos no estaba indicada.

Introduction: Stress ulcer prophylaxis (SUP) is commonly used in Paediatric Intensive Care Units (PICUs). However, strong evidence for this practice is lacking and there is a dire need for paediatric randomized controlled trials (RCTs). Our aim was to assess the usefulness of SUP with omeprazole in critically ill children. Patients and methods: We conducted a randomized, controlled open-label trial, including 144 children admitted into a PICU with a paediatric Sequential Organ Failure Assessment (pSOFA) score of less than 16. We randomly allocated patients to SUP with omeprazole or no SUP. The primary outcome was development of upper gastrointestinal bleeding or nosocomial infection. Results: The incidence of gastrointestinal bleeding was 27.1%, but clinically significant bleeding developed in only 5.6% of patients. We did not find a significant difference in the incidence of bleeding between the prophylaxis and control groups (27.8% vs 26.4%; P = .85). We also did not find a significant difference between the groups in the incidence of ventilator-associated pneumonia (VAP) (9.6% vs 8.3%; P = .77). The incidence of central line-associated bloodstream infection (CLABSI) was higher in the prophylaxis group compared to the control group (30.6% vs 12.5%; P = .014). None of the patients developed Clostridium difficile-associated diarrhoea. We did not find significant differences in mortality, length of PICU stay or duration of mechanical ventilation. Mechanical ventilation was an independent predictor of bleeding (OR, 6.4; 95%CI, 2.73–14.9). Conclusion: In PICU patients with mild to moderate organ dysfunction, omeprazole does not seem to be useful for prevention of gastrointestinal bleeding while at the same time increasing the risk of CLABSI. Thus, we recommend restricting SUP to mechanically ventilated children. Resumen: Introducción: La profilaxis de las úlceras por estrés (PUE) se utiliza comúnmente en las Unidades de Cuidados Intensivos Pediátricos (PICU). Sin embargo, no hay pruebas sólidas que apoyen esta práctica y se necesitan urgentemente ensayos clínicos controlados aleatorios (ECCA) pediátricos. Nuestro objetivo era evaluar el valor de la PUE con omeprazol en pacientes críticos pediátricos. Pacientes y métodos: Ensayo controlado aleatorio abierto, con inclusión de 144 niños ingresados en la UCI con una puntuación en la escala pediátrica de evaluación del fallo multiorgánico secuencial (pSOFA) inferior a 16. Los pacientes fueron asignados al azar a recibir omeprazol para el PUE o a no recibir profilaxis. La variable de resultado principal fue el desarrollo de hemorragia digestiva alta o infecciones nosocomiales. Resultados: La frecuencia de hemorragia gastrointestinal fue del 27.1%, aunque solo desarrollaron hemorragia clínicamente significativa el 5,6% de los pacientes. No se observaron diferencias significativas en la incidencia de hemorragia entre los grupos de profilaxis y de control (27,8% vs. 26,4%; P = ,85). Tampoco surgieron diferencias significativas en la incidencia de la neumonía asociada al ventilador (NAV) entre ambos grupos (9,6% vs. 8,3%; P = ,77). La incidencia de bacteriemia asociada a catéter venoso central (BACVC) fue mayor en el grupo de profilaxis en comparación con el grupo de control (30,6% vs. 12,5%; P = ,014). Ningún paciente desarrolló diarrea por Clostridium difficile. No se encontraron diferencias significativas en la tasa de mortalidad, la duración de la estancia en la UCIP o la duración de la ventilación mecánica. La ventilación mecánica fue un predictor independiente de hemorragia (OR, 6,4; IC 95%: 2,73–14,9). Conclusión: En pacientes ingresados en la UCIP con disfunción orgánica de leve a moderada, el uso de omeprazol parece ineficaz para la prevención del sangrado gastrointestinal a la vez que aumenta el riesgo de BACVC. Se recomienda restringir el PUE a niños sometidos a ventilación mecánica.

A lesão aguda de mucosa gástrica (LAMG) é uma condição geralmente associada a pacientes críticos que pode evoluir para ulceração e hemorragia. Sua incidência é alta, porém a prevalência de sangramento significativo é baixa. Dessa forma, recomenda-se o uso de medicamentos que inibem a secreção ácida, como os inibidores de bomba de prótons (IBP). Existem condições clínicas específicas que demandam o uso dessa profilaxia, dentre elas fatores maiores e menores, de acordo com o grau de evidência na literatura. Os IBP são mundial e indevidamente utilizados, o que pode conferir desfechos clínicos desfavoráveis, principalmente no uso prolongado, como deficiências nutricionais, infecções por Clostridium difficile, demência, pneumonia comunitária, fraturas ósseas, injúria renal, além de resultar em elevados gastos. No Hospital Universitário Antônio Pedro, observa-se a mesma tendência de prática, com uso sem indicações precisas e elevados gastos. O presente trabalho propôs avaliar o uso do único IBP padronizado na instituição, o omeprazol, através de um estudo observacional e retrospectivo. A coleta de dados foi realizada a partir dos registros provenientes da planilha de avaliação de uso do omeprazol para profilaxia de LAMG, que contém dados sociodemográficos e clínicos, dados do omeprazol e os fatores de risco. Para a definição dos fatores de risco considerados nesta planilha, foi realizada uma pesquisa bibliográfica e a consulta da opinião de quatro especialistas diferentes. Todos esses dados foram tabulados em planilhas específicas utilizando o software Microsoft Excel® e os resultados mensurados através de estatística descritiva. Do período de agosto a outubro, foram computados 116 registros de prescrição de omeprazol para profilaxia de LAMG, sendo 62,9% referentes a pacientes do sexo masculino, com média de idade de 61 anos, oriundos majoritariamente (40,5%) do setor de terapia intensiva. Nota-se a ocorrência maior de uso na dose de 40 mg/ dia (57,8%), sendo esses utilizados principalmente por via oral (53,4%). 34,5% dos registros referiam-se a pacientes com condições de switch para via oral/enteral, resultando em uma possível economia de 996 reais. Apenas 13,8% dos registros avaliados apresentavam fatores que indicam necessidade de profilaxia de LAMG. 10,3% denotam pelo menos um fator maior que justifique o uso, dos quais 5,2% do total de registros são referentes a sangramento do trato gastrointestinal. Somente 3,5% apresentavam dois ou mais fatores menores, sendo o mais prevalente a anticoagulação em dose terapêutica (10,3%), seguido de corticoide em dose equivalente a 250 mg hidrocortisona/dia (9,5%). Este trabalho está de acordo com estudos brasileiros, em que a maior parte das indicações é discutível e o uso é, sobretudo, inadequado (Fioramonte et al., 2020; Araújo et al., 2021). Com esses resultados, pretendese racionalizar o uso de IBP, reduzir custos e embasar a construção de um protocolo clínico de profilaxia de LAMG para o hospital.

Introduction: Omeprazole is one of the most used proton-blocking molecules applied in the gastric ulcer treatment. Its blocking effect is achieved by the presence of both acidic and basic nitrogen heteroatoms in its composition. Nevertheless, due to its collateral effects, which may be moderate to severe, the development of its electrochemical determination is really actual. Methods: In this work, we describe theoretically the possibility of omeprazole electrochemical determination, assisted by the composite, containing the silver (I, III) oxide as an active substance and the polymer of 1,2,4-triazolic derivative as a mediator. In this case, the omeprazole molecule is gradually oxidized yielding firstly phenolic and then quinonic derivative. The pyridinic nitrogen is oxidized later. Results: The electroanalytical process is described by a trivariant equation-set, analysis of which confirms the efficiency of the composite of poly(1,2,4-triazole) with Ag2O2. The electrochemical oscillations are also possible, being realized beyond the detection limit. Conclusion: The composite of poly(1,2,4-triazole) with Ag2O is suitable for omeprazole electrochemical determination both in vivo and in vitro. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Ciencias Químico-Farmacéuticas is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Erosive and ulcerative lesions of the squamous and glandular gastric mucosa are a common disease of the equine stomach. In the past, these lesions in different regions of the mucosa were summarized as one disease (Equine Gastric Ulcer Syndrome) and research focused mainly on the squamous gastric mucosa. Today, findings raised awareness of different underlying pathologies depending on the gastric region. This led to the development of a more precise terminology and the differentiation in Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD). However, therapy especially of the glandular regions (EGGD) is challenging as treatment protocols such as omeprazole/sucralfate seem less effective as the effects are on squamous lesions. The retrospective study was performed to investigate the efficacy of a monotherapy with misoprostol in comparison to omeprazole/sucralfate and a combined therapy of omeprazole and misoprostol. Therefore, 67 horses which underwent gastroscopic examination were included in the study. The horses were either presented due to acute colic as an emergency and examined during the hospitalisation or had been referred due to behavioural abnormalities and intermittent mild colic symptoms. The horses had glandular and squamous gastric lesions and the group included 31 geldings, 35 mares and one stallion. 50 of the equine patients were Warmblood horses and 17 of them were ponies. Scoring was performed following suggestions of the Consensus statement of the European College of Equine Internal Medicine (2015) and Banse and Andrews (2019). Findings before and after treatment were evaluated retrospectively. 29 horses were treated with omeprazole (2–4mg/kg q. 24h) and sucralfate (12mg/kg q. 12h), 28 horses were treated with misoprostol (5µg/ kg q. 12h) and 10 horses were treated with omeprazole (2–4mg/kg q. 24h) and misoprostol (5µg/kg q. 12h). Mean duration of therapy was 28 days (omeprazole/sucralfate and misoprostol) and 35 days (omeprazole/misoprostol). The horses were discharged from the clinic after the first gastroscopic examination and respective treatment was done at home by their owners until the follow-up examination. A detailed medication protocol was explained and given to the owners as well as a feeding and management advice. Four horses were excluded from the study because they developed mild colic symptoms and lethargy under therapy with misoprostol. Mean EGGD scores decreased significantly under therapy with misoprostol in all examined localisations as follows: fundus p=0.005, antrum pyloricum p=0.003, pylorus p=0.001. Significant improvements after therapy with omeprazole/sucralfate in the glandular region included exclusively the pylorus (p=0,038). EGGD scores decreased non-significantly after treatment with omeprazole and misoprostol. Post-treatment ESGD scores did not show improvement after the therapy with omeprazole/sucralfate. Monotherapy with misoprostol was superior to omeprazole/sucralfate and omeprazole/misoprostol for ameliorating glandular lesions of the equine stomach. This resembles the results of Varley et al. (2019). There was no worsening of ESGD-lesions following therapy with misoprostol like it has been reported in a study of Pickles et al. (2020). Therapy with omeprazole and sucralfate had only little efficacy on lesions of the glandular mucosa and did not have positive effects on squamous lesions. To date, there is no compound containing misoprostol available for equine veterinary medicine in Germany. The authors highly request further research concerning alternative therapeutical options for horses with EGGD and the improvement of their availability for veterinary medicine in Germany. [ABSTRACT FROM AUTHOR]

Introduction: Upper gastrointestinal bleeding prophylaxis with omeprazole is a frequent practice in patients admitted to the ICU. Infectious complications related to this therapy are currently being investigated. Objective: to determine the frequency with which early omeprazole prophylaxis is used in patients admitted to the ICU and to describe its clinical outcomes. The secondary objective was to determine the risk factors associated with the most frequent stress ulcers. Methods: a retrospective, descriptive study was conducted in a sample of patients admitted to the ICU of Hospital Santo Tomás in 2019. Results: 114 patients were included, with a median age of 40 years (IQR, 28-58), male predominance (60.53%) and a median time in ICU of 12 days (IQR, 6-24). 111 patients (97.37%) received early prophylaxis with omeprazole. In the group that received early prophylaxis, upper gastrointestinal bleeding occurred in 2.70% of cases; 40 patients (36.04%) presented nosocomial pneumonia and 1 patient (0.90) presented Clostridium difficile infection. In the sample studied, 110 patients (96.49%) used mechanical ventilation; 85 patients (74.56%) presented shock and 44 patients (38.60%) developed acute kidney injury. Conclusions: Early prophylaxis with omeprazole is a common practice in patients admitted to ICU. Upper gastrointestinal bleeding occurred infrequently. One third of the patients who received this treatment presented nosocomial pneumonia, being Clostridium difficile infection a rare complication. The use of mechanical ventilation and shock were the most frequent risk factors for stress ulcers. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Ankara Training & Research Hospital is the property of Medical Journal of Ankara Training & Research Hospital and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Erosive esophagitis secondary to radiotherapy is an unusual complication in the oncological treatment of thoracic tumors. This pathological entity is associated with multiple complications, which is a clinical challenge for health workers unfamiliar with the clinical manifestations. Clinical case: A 64-year-old woman with a 3-day clinical picture of chest pain radiating to the epigastrium with 10/10 intensity. On physical examination, she was tachycardic, hypotensive, and with intense pain in the upper hemiabdomen region; she had no signs of peritoneal irritation on deep palpation. Paraclinical tests showed no signs of local or disseminated infection, but endoscopy of the digestive tract reported post-radiation esophagitis. Discussion: Erosive esophagitis after radiotherapy occurs in less than 1 % of cases, and clinical manifestations such as dysphagia, odynophagia, and abdominal pain are common. Initial symptomatic management is preserved, with supportive measures such as intravenous hydration and proton pump inhibitors (PPIs). In case of intolerance to the oral route, therapy with nutritional support is indicated via nasogastric tube or gastrostomy in the most severe cases. [ABSTRACT FROM AUTHOR]

Introducción: la esofagitis erosiva secundaria a la radioterapia es una complicación inusual del tratamiento oncológico de los tumores torácicos. Esta entidad patológica está asociada con múltiples complicaciones, lo que resulta un reto clínico para los profesionales en salud que están poco familiarizados con las manifestaciones clínicas. Caso clínico: mujer de 64 años con cuadro clínico de 3 días de dolor torácico irradiado al epigastrio con intensidad 10/10. En el examen físico se encontró taquicárdica, hipotensa, con dolor intenso en la región hemiabdominal superior; a la palpación profunda no tenía signos de irritación peritoneal. Los paraclínicos no mostraron signos de infección local o diseminada, pero la endoscopia de vías digestivas reportó esofagitis posirradiación. Discusión: la esofagitis erosiva posterior a la radioterapia se presenta en menos del 1 % de los casos, las manifestaciones clínicas como disfagia, odinofagia y dolor abdominal son frecuentes; el manejo sintomático inicial es conservado, con medidas de soporte como hidratación intravenosa e inhibidores de la bomba de protones (IBP). En caso de intolerancia a la vía oral se indica terapia con soporte nutricional por sonda nasogástrica o gastrostomía en los casos más graves.

Objective: Here, we planned to evaluate whether fraxin performed a gastroprotective activity or not with its antioxidant properties on the ethanol-induced gastric ulcer. Methods: Wistar Albino male rats were assigned to 4 groups with 6 animals in each group. The groups were arranged as control (group I), ethanol (group II), ethanol+omeprazole (group III), and ethanol+fraxin (group IV) groups. All subjects were sacrificed 3 hours after administration of 70%, 10 mg/kg of ethanol. In groups III and IV, rats were given omeprazole 30 mg/kg and fraxin 50 mg/kg, respectively, by oral gavage 30 minutes before the ethanol induction. At the end of the experiment, the gastric tissues were removed, washed and the ulcer areas were macroscopically evaluated. Later, the samples were stored under appropriate conditions for biochemical analysis. Results: Superoxide dismutase (SOD) and glutathione (GSH) levels decreased, and malondialdehyde (MDA) value increased in group II compared to group I (p<0.05). However, these results changed significantly in groups III and IV (p<0.05). In group III, a significant reduction was noticed in gastric ulcer areas compared to group II (p<0.05). In group IV, the size of the gastric ulcer areas decreased considerably compared to group II (p<0.05). Conclusion: In the light of biochemical and macroscopic findings, fraxin showed a gastroprotective effect with its antioxidant activity against ethanol-induced gastric ulcers. [ABSTRACT FROM AUTHOR]

Equine Gastric Ulcer Syndrome (EGUS) is a common problem in equine athletes. The ECEIM consensus statement and the manufacturers recommend omeprazole at a dosage of 2–4 mg/kg PO SID (buffered formulations) or 1–2 mg/kg PO SID (enteric coated granules) for the treatment of ESGD (Equine Squamous Gastric Disease) and the same dosages in combination with sucralfate (12 mg/kg PO BID) for EGGD (Equine Glandular Gastric Disease). In this study, the two formulations were compared in an equine hospital setting. A modified clinical scoring was used to include 87 horses (January 2019-December 2020) presented for recurrent colic, weight loss, exercise insufficiency or typical behavior (bruxism, groaning), in which gastroscopy was performed. Horses were classified as 0–4 for ESGD (consensus statement) and 0–3 for EGGD (modified from non-remarkable/mild/moderate/severe findings according to the Consensus statement) by the veterinarian performing the gastroscopy and led to the recommendation of therapy in 63 cases. Omeprazole therapy (buffered formulation 4 mg/kg PO SID, GastroGard™, Boehringer Ingelheim or enteric coated granules 2 mg/kg PO SID, Equizol™, CP Pharma), in case of EGGD combined with sucralfate (12 mg/kg PO BID, Sucrabest™, Combustin) was recommended in combination with improvements concerning housing, feeding and reduction of stress according to the ECEIM consensus statement. Gastroscopy was repeated about 4 weeks later in 23 horses. Standing images were randomized and scored twice by two blinded, experienced observers (ECEIM diplomats), so that 4 scorings for both time-points were available of ESGD and EGGD. The mean values of these scorings were the basis for the evaluation of treatment success. Additionally, inter- and intra-observer agreement were compared for ESGD and EGGD. Both formulations were highly effective in improving ESGD by ≥ 2 subgrades or by achieving grade 0 in 93 % and 100 % of horses treated with buffered (n = 15 GastroGard™) and encapsulated formulations (n = 8, Equizol™), respectively. EGGD was improved by ≥ 1 subgrade or achieving grade 0 in 64 % and 71 % of horses treated with buffered and enteric coated formulations combined with sucralfate, respectively. No significant differences between the two formulations were found for either ESGD or EGGD (P > 0.999). Inter- and intra-observer-agreement were excellent for ESGD (κ = 0.832–0.975), while the inter-observer agreement for EGGD was found to be fair (κ = 0,390). In conclusion, both omeprazole formulations can be recommended for the treatment of EGUS, in particular ESGD. Differences in long-term effect and recurrence rates should be studied in future studies. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nephrology & Dialyzotherapy / Nefrologia i Dializoterapia Polska is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

O primeiro inibidor da bomba de prótons (IBP) comercializado no mundo foi o omeprazol. É hoje amplamente prescrito na Atenção Básica brasileira. Estudos indicam que o uso a longo prazo pode estar relacionado a efeitos adversos importantes na qualidade de vida do paciente. Assim, o objetivo foi avaliar a prevalência e o perfil clínico de pacientes idosos em uso de omeprazol em uma Unidade de Saúde da Família (USF). Foi realizado um estudo transversal descritivo em que foram avaliados pacientes idosos, usuários de uma USF. Foram incluídos no estudo 100 pacientes idosos. Desses, 35 faziam uso do omeprazol, sendo 10 do sexo masculino e 25 do sexo feminino. A dose de 20 mg diária foi encontrada em 68,6% dos usuários, 91,4% tem prescrição por mais de doze meses e 51,4% não possuíam registro do motivo de uso do omeprazol, 17,1% tinham descrito epigastralgia como justificativa de uso. O omeprazol pode estar sendo prescrito sem uma clara indicação de uso e por tempo de tratamento prolongado, colaborando para o uso inadequado desse medicamento.

Background. The interrelation between omeprazole use and the possibility of developing nosocomial pneumonia, acute kidney damage and Clostridium difficile-induced diarrhea in patients with sepsis requires further study. Material and methods. 200 patients with severe craniocerebral injury that underwent surgery for the pathology and developed sepsis in the postoperative period were examined in a blind, randomized placebo-controlled research study. The patients were divided into two groups. Patients in Group 1, as part of their therapy regimen for sepsis, received a daily dose of 0.2 mg/kg omeprazole as an intravenous infusion; patients in Group 2 received placebo instead of omeprazole, in addition to a similar therapy regimen as Group 1. Results. Among patients receiving omeprazole, the number of concomitant ventilatorassociated pneumonia cases increased by 1.32 times, the number of acute kidney damage cases by 1.33 times and the number of cases of Clostridium difficile toxin secretion with feces by 1.75 times. Conclusions. The routine use of omeprazole in the management of patients with sepsis may worsen treatment results. [ABSTRACT FROM AUTHOR]

Objective: To analyze, using the medication review program, Revisem®, the prevalence of drug-related problems (DRP) in patients in the province of Valencia who were on active treatment with proton pump inhibitors (PPI) in 2022., Design: Descriptive and retrospective observational study., Material and Methods: The pharmacotherapeutic history of 295 patients was analyzed following the criteria proposed by the Pharmaceutical Care Network Europe, using the Revisem® digital platform of the Muy Ilustre Colegio Oficial de Farmacéuticos (MICOF)., Results: The mean age of the patients was 81.8 ± 11.1 years and 66.4% were women. At least one DRP was detected in 97.3% of patients. 46.9% of the DRP analyzed were interactions, of which 29.7% involved a PPI, with omeprazole being the most frequent. DRPs with PPI are significantly related to certain patient conditions and pharmacological groups, such as female sex, age over 54 years and polypharmacy., Conclusions: The application of the Revisem® digital platform allows the detection of a high prevalence of DRP at the provincial level. The application of new technological tools to detect the prevalence of DRP is essential to optimize patient treatments., (Copyright © 2023 The Authors. Publicado por Elsevier España S.L.U. All rights reserved.)

Objetivos: Evaluar la actividad antimicrobiana del hidróxido de calcio en combinación con omeprazol, a diferentes concentraciones, frente a E. faecalis.Materiales y métodos: Estudio experimental in vitro en el que se probó la actividad antimicrobiana del hidróxido de calcio y de hidróxido de calcio más omeprazol en diferentes concentradones (1, 5, 8 y 10 %) frente a E. faecalis, determinando la sensibilidad antimicrobiana en cada uno de los grupos. El análisis estadístico de los datos se realizó mediante la prueba estadística Shapiro Wilk y luego se utilizó la prueba no paramétrica de U Mann-Whitney.Resultados: Se obtuvo una notable sensibilidad de la bacteria al omeprazol, la cual se incrementa a medida que se aumenta la concentración de omeprazol. El grupo de hidróxido de calcio con omeprazol al 10 % tuvo el mayor porcentaje de inhibición (87,7), luego al 8 % con (71,9), al 5 % (67,8) y al 1 % (64,1).Conclusiones: Hay un notable incremento de la actividad antimicrobiana de hidróxido de calcio combinado con omeprazol frente a Enterococcus faecalis.

The stability of a lyophilized product is very sensitive to the effect of residual humidity, for that reason it is important not only to control it in every stage of the process of lyophilization, but also the preparation of the packaging material to use. The objective of the present work was to evaluate the influence of the treatment received by bromobutyl freeze drying closures on the residual moisture content of the lyophilized injectable omeprazole 40 mg. The three bromobutyl freeze-dried closures batches of 20 mm were tested, sterilized by moist heat and dried. The moisture content of three industrial batches of omeprazole was estimated using sterile and dried closures, for twelve months, by Karl Fischer technique, as well as the assay of the injectable by a chromatographic method. It were successfully demonstrated that the closure's weight increased, as a result from the humidity absorption associated to the sterilization process. The drying process of the closures decreased the initial moisture content. The industrial batches of the freeze-dried injectable omeprazole, by using sterile and dry bromobutyl closures, kept the moisture content within the established limit, for twelve months, as well as the assay, without risks for the quality of the final product. [ABSTRACT FROM AUTHOR]

The bioavailability of omeprazole, which is the most important drug to treat ESGD or EGGD, depends on gastric emptying and acidity of the gastric fluid and impacts its pharmacokinetics and the efficacy of this drug. The objective of this study was to measure primarily the gastric emptying time during non-feeding and feeding period after oral administered omeprazole and secondly the decrease of omeprazole plasma concentration induced by the acidotic intragastric pH during the non-feeding period. The dosage of omeprazole (Gastrogard®) in three adult Warmblood horses with ESGD grade II was 4 mg/kg bwt. The first dosage was given at the beginning of intragastric pH measurement, the second 24 h and the third 36 h later. Plasma samples for omeprazole analysis were collected before and at the time points of 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210, 240, 300, 360 and 540 minutes after every omeprazole application. Omeprazole was detected by LC-mass spectrometry and the measurment range was from 0.1 to 10 mg/L. Parameters of pharmacokinetics were Tmax, Cmax und AUC240. The intragastric pH probe guided with a gastroscope was inserted into the stomach located into the gastric fluid of a horse, which had no food but free access to water. At the beginning the pH measurements started with a four hours non-feeding period followed by a 44 hours period of feeding of hay ad libitum and free access to water. After the first omeprazole application and during the non-feeding period medians of Tmax (70.2 min), Cmax (0.85 mg/L) and AUC240 1.99 h*mg/L) were longer, decreased and smaller in comparison to feeding period after the second (49.8 min, 1.07 mg/L, 1.71 h*mg/L) and third (55.2 min, 1.08 mg/L, 2.16 h*mg/L) dosage of omeprazole. The half-life is significantly longer during feeding in comparison to the non-feeding period. After the first dosage the intragastric pH measurements of two electrodes were 2.9 and 2.5 (median) over a period of 10.66 h and 17.05 h including of four hours non-feeding period. After that period and after the second and third application the intragastric pH was continuous above four. In summary Tmax characterises the gastric emptying rate, which is shorter during feeding. Therefore Gastrogard® should be administered during feeding and the Cmax and AUC240 will be increased. Based on this, the bioavailability of omeprazole will be optimized. During a non-feeding period, the gastric fluid is acidotic (pH 2.5-2.9), which increases Tmax and prolongs gastric emptying rate, which reduces bioavailability of acid-labile omeprazole in this drug! [ABSTRACT FROM AUTHOR]

Objective: To describe the pharmaceutical interventions of a vertical clinical pharmacy service to promote the rational use of intravenous omeprazole. Methods: A prospective and descriptive study carried out at a university hospital in the Midwestern Region of Brazil, from November 2014 to May 2015. The service consisted of the analysis of adequacy of the route of administration of omeprazole in relation to the clinical conditions of the patient, as well as the use of the appropriate diluent. Interventions were recorded in medical records and subsequently evaluated for acceptance. Results: A total of 770 prescriptions were evaluated. Interventions related to diluent replacement were more accepted (p<0.001), and surgeons were the specialty that used the intravenous route inappropriately (p<0.001). Conclusion: Although partially accepted, pharmaceutical interventions could contribute to improve patient safety, since they allowed the use of a safer route of administration. [ABSTRACT FROM AUTHOR]

Introducción: El elevado consumo de inhibidores de la bomba de protones (IBP) puede incrementar la probabilidad de aparición de interacciones clínicamente relevantes. Pacientes mayores, polimedicados y pluripatológicos representan un grupo de alto riesgo. Se espera que la revisión sistemática de las prescripciones electrónicas (PE) permita detectar potenciales interacciones farmacológicas. Material y métodos: Estudio retrospectivo, transversal y observacional: revisión de las PE de IBP dispensadas entre enero y diciembre de 2015 en una farmacia comunitaria rural. Resultados: 1.186 PE, 164 pacientes (edad 65,7±17,2). Mayor número de pacientes en rango de edad 71-80 (n=52). Medicamentos por paciente: 11,0±5,6. PE IBP sin indicación aprobada: 27%. Indicación mayoritaria: protección frente a gastrolesión (77%). 29 pacientes (30%) con riesgo de resultados negativos asociados a la medicación (RNM) por omeprazol, 15 de ellos sin indicación. Patologías concomitantes más prevalentes: hipertensión arterial (n=81), dislipemia (n=61) y diabetes (n=36). Principios activos implicados: acenocumarol, hierro, cianocobalamina, escitalopram, benzodiazepinas y clopidogrel. Discusión: El 80% de las PE de omeprazol corresponde a pacientes entre 61 y 90 años, la mayoría con comorbilidad y polifarmacia, y supera el tiempo de tratamiento recomendado. Relacionamos la cronificación y el aumento del riesgo de RNM con la ausencia de un seguimiento adecuado. Muchos fármacos corresponsables del riesgo tratan los problemas de salud (PS) más prevalentes de nuestra población: la probabilidad de interacción resulta independiente de la correcta indicación del IBP. Conclusiones: La revisión de las PE permite valorar el riesgo de RNM y evaluar la información básica relativa al riesgo de interacción. Se detectaron RNM de no necesidad y de inseguridad en proporciones comparables. Un número elevado de PE de omeprazol tienden a cronificarse. Las interacciones más relevantes registradas ocurren a nivel metabólico.

Omeprazole (OMP) and ketoconazole (KTZ) have been shown to activate the AHR signaling pathway in spite of the fact that they bind to the receptor with low or no affinity. The aim of this study was to investigate whether KTZ and OMP can act as indirect activator of AHR. In order to evaluate the effects of KTZ and OMP on AHR signaling, we measured cytochromes p450 (CYP1A1) enzyme activity by ethoxyresorufin-O-deethylase (EROD) assay as endpoint. FICZ, at 1nM concentration, caused a transient elevation in the catalytic activity of CYP 1A1. KTZ and OMP were found to be inducer of CYP1A1 at concentrations above 50 µM. At early time of incubation (3hr), a dose-dependent inhibition of FICZ-induced EROD activity was seen. When OMP or KTZ were added together with FICZ, a prolonged activation of CYP1A1 was observed at later time of incubation (24h). Taken together, our findings support the earlier observation that we shown that CYP 1A1 inhibitors can act as an AHR activator though inhibition of metabolic degradation of FICZ.

Los Inhibidores de la bomba de protones son fármacos muy frecuentemente utilizados en la práctica clínica por su conveniencia y bajo coste. Sin embargo, no están exentos de ciertos problemas. Se presenta el caso de una paciente de 78 años de edad, polimedicada en la que tras seguimiento farmacoterapéutico se identifica una posible relación entre el uso prologado del omeprazol y una pérdida progresiva de peso así como la aparición de astenia.

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La warfarina es el anticoagulante más empleado en el mundo por su conveniencia y bajo costo. Sin embargo, su efectividad y seguridad están determinadas por el monitoreo paraclínico del INR, el control de la ingesta de vitamina K, las interacciones medicamentosas y el perfil farmacogenético entre otros factores, que podrían condicionar la ocurrencia de complicaciones trombóticas o hemorrágicas. Se presenta el caso de una paciente con hemorragia en el muslo secundaria a warfarina, en quien la falta de adherencia al esquema posológico prescrito, la falta de seguimiento y una posible interacción con el omeprazol fueron identificados por el servicio de Farmacia Clínica del hospital como factores determinantes de la reacción adversa a medicamento. La intervención farmacéutica consistió en sugerir la sustitución de warfarina por apixabán, medicamento de una costo-efectividad similar, que no requiere monitoreo paraclínico y carece de interacciones medicamentosas en la paciente.

En este trabajo se describen y evaluan las posibles cascadas de prescripción de medicamentos en la población mayor de 65 años en la provincia de Guadalajara (España). La muestra de pacientes estudiada está polimedicada con una media de 8 medicamentos por paciente y dia. En esta población los fármacos más prescritos son, por este orden: paracetamol, omeprazol, lactulosa, cianocobalamina y furosemida. En la prescripción de fármacos se han encontrado algunas asociaciones que guardan una relación estadísticamente significativa: omeprazol y prescripción de vitamina B12, se ha detectado en tres ancianos de cada diez que toman omeprazol. Igualmente se ha evidenciado la relación entre el uso de paracetamol y prescripción de preparados de calcio, que afecta a casi uno de cada cuatro ancianos que consume paracetamol, la relación entre el consumo de omeprazol y preparados de calcio, que afecta al 19% , la relación furosemida con preparados de calcio afectando al 47,9% de los pacientes en tratamiento con furosemida y la relación metformina- vitamina B12 afectando casi al 38% de los pacientes que consumen metformina y casi al 6% de la población estudiada.

Introducción: Los inhibidores de la bomba de protones (IBP) son fármacos ampliamente utilizados, si bien esto conlleva a un sobreuso que no es acorde con las indicaciones aceptadas en España y en el resto de Europa. Por otro lado, algunos autores han establecido una posible implicación de los IBP en el riesgo de fractura. Con este trabajo hemos pretendido efectuar una primera aproximación al conocimiento del consumo de IBP en nuestro medio y analizar para qué indicación son prescritos, a la vez que estudiar su posible asociación con un mayor riesgo de fractura por fragilidad entre sus consumidores. Material y método: Estudio observacional, transversal, abierto, descriptivo, en el que se entrevistó aleatoriamente a un número de pacientes que fueron atendidos en diferentes ámbitos sanitarios: consultas externas hospitalarias, servicios de urgencias, consulta de Atención Primaria y pacientes ingresados en planta hospitalaria. Resultados: De los 411 pacientes entrevistados, el 54% de los pacientes recibían IBP, y cuya edad media era de 63,3 años, frente al 46% que no los tomaban y que eran más jóvenes, con una edad media de 50,9 años. La distribución por sexos fue similar. La principal razón de utilizar el IBP era como “protector gástrico”, en el 39,8% de los pacientes, indicación no existente en la ficha técnica de este grupo de fármacos. Los consumidores de IBP tenían una mayor prevalencia de todas las fracturas por fragilidad. Conclusiones: Más de la mitad de la población encuestada consume IBP, y de ella cerca del 40% sin una indicación médica correcta. Por esto, unido a la mayor prevalencia de fracturas por fragilidad que presentan –que nos hace pensar en un posible mayor riesgo de fractura entre sus usuarios– consideramos la necesidad de un uso más racional de estos fármacos. Estas conclusiones son preliminares pero, a la vista de estos resultados, creemos que puede ser interesante realizar más estudios dirigidos a comprobar de manera más firme la relación entre los IBP y el riesgo de fractura osteoporótica.

AbstractObjective:The aim of this study was to compare protective effects of ischemic and potential protective effects of pharmacological preconditioning with omeprazole on isolated rat heart subjected to ischemia/reperfusion.Methods:The hearts of male Wistar albino rats were excised and perfused on a Langendorff apparatus. In control group (CG) after stabilization period, hearts were subjected to global ischemia (perfusion was totally stopped) for 20 minutes and 30 minutes of reperfusion. Hearts of group II (IPC) were submitted to ischemic preconditioning lasting 5 minutes before 20 minutes of ischemia and 30 minutes of reperfusion. In third group (OPC) hearts first underwent preconditioning lasting 5 minutes with 100μM omeprazole, and then submitted 20 minutes of ischemia and 30 minutes of reperfusion.Results:Administration of omeprazole before ischemia induction had protective effect on myocardium function recovery especially regarding to values of systolic left ventricular pressure and dp/dt max. Also our findings are that values of coronary flow did not change between OPC and IPC groups in last point of reperfusion.Conclusion:Based on our results it seems that ischemic preconditioning could be used as first window of protection after ischemic injury especially because all investigated parameters showed continuous trend of recovery of myocardial function. On the other hand, preconditioning with omeprazole induced sudden trend of recovery with positive myocardium protection, although less effective than results obtained with ischemic preconditioning not withstand, we must consider that omeprazole may be used in many clinical circumstances where direct coronary clamping for ischemic preconditioning is not possible.

OBJECTIVES: Epidemiological studies have shown a relationship between long-term use of proton pump inhibitors and bone metabolism. However, this relationship has not yet become established. The aim of the present study was to analyze the mechanical properties and bone mineral density (BMD) of rats that were subjected to long-term omeprazole use.METHODS: Fifty Wistar rats weighing between 200 and 240 g were divided equally into five groups: OMP300 (omeprazole intake at a dose of 300 µmoL/kg/day); OMP200 (200 µmoL/kg/day); OMP40 (40 µmoL/kg/day); OMP10 (10 µmoL/kg/day); and Cont (control group; intake of dilution vehicle). The solutions were administered for 90 consecutive days. After the rats had been sacrificed, their BMD, the mechanical properties of the dissected femurs and their serum Ca++ levels were analyzed.RESULTS: The BMD of the OMP300 group was lower than that of the controls (p = 0.006). There was no difference on comparing the OMP200, OMP40 and OMP10 groups with the controls. The maximum strength and rigidity of the femur did not differ in the experimental groups in comparison with the controls. The OMP300 group had a statistically lower serum Ca++ concentration than that of the controls (p = 0.049), but the other groups did not show any difference in relation to the controls.CONCLUSION: Daily intake of 300 µmoL/kg/day of omeprazole decreased the BMD of the femur, but without changes to the rigidity and strength of the femur in adult rats.

Introducción: Omeprazol es uno de los fármacos más prescritos dentro del Sistema Nacional de Salud español. Su perfil de seguridad se considera alto, aunque aparecen descritas en la ficha técnica diferentes reacciones adversas, algunas de ellas, aunque poco o muy poco frecuentes, de carácter grave. Evidencias clínicas y estudios recientes han puesto de manifiesto una relación del uso continuado de omeprazol con otras manifestaciones adversas. Objetivos: Conocer qué parte de la población tratada sobrepasa la duración del tratamiento según lo consignado en la ficha técnica para el tratamiento de la esofagitis por reflujo y qué proporción puede presentar un riesgo potencial de sufrir alguna reacción adversa en las circunstancias en las que se han detectado. Pacientes y métodos: Estudio observacional multicéntrico cuya recogida de datos se efectuó en 27 farmacias comunitarias ubicadas en 24 localidades de la provincia de Badajoz mediante un cuestionario estructurado con cinco preguntas relacionadas con el uso de omeprazol. Resultados: El 60% de los pacientes estudiados sobrepasan ampliamente el tiempo de tratamiento para tratar el reflujo gastroesofágico según la ficha técnica. El porcentaje era del 39% en pacientes de más de 70 años. Un 4,5% de pacientes de edad avanzada llevaba tomando omeprazol a dosis altas durante un tiempo prolongado (más de un año), circunstancia que los hace más vulnerables a sufrir alguna de las reacciones adversas descritas.

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The increased incidence of esophageal adenocarcinomas is a complication of duodenal reflux oesophagitis. D-002 has an oesophageal-protective effect demonstrated in different experimental models of acute and chronic esophagitis. In order to evaluate the influence of D-002 in esophageal adenocarcinomas formation induced by experimental duodenal esophageal reflux (DER) in rats, male SD rats were used. The animals were divided into five experimental groups, one control without DER, and four with DER induction by surgical procedure and receiving treatment with D-002, indomethacin and omeprazol at doses of 2, 20 y 200 mg/Kg, respectively, over a period of 16 weeks. At the end of treatments, the esophagus macroscopically was evaluated and the ILE was determined. Subsequently, the esophageal tissue was preserved in formaldehyde for histological analysis. The results showed that D-002, indomethacin and omeprazole treatments, significantly reduced (40, 35 and 50%, respectively) ILE; therefore, there were no significant histologic changes compared to positive control (DER). We concluded that oral administration of D-002 may be used as long-term treatment of duodenal reflux esophagitis, although not reverse the esophageal histological changes induced by duodenal reflux. [ABSTRACT FROM AUTHOR]

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Objetivo: Evaluar el efecto de la interacción clopidogrel-omeprazol en el reingreso hospitalario de pacientes por recidiva de síndrome coronario agudo (SCA) Diseño: Estudio de casos y controles Emplazamiento: IPS Universitaria Clínica León XIII, Medellín, Colombia. Participantes: Se seleccionaron a partir de una población prevalente, entre 2009-2010, pacientes con uso de clopidogrel de forma ambulatoria (menor a un año y superior a 30 días), y la estancia hospitalaria por un SCA o la presencia de un SCA previo. Medidas principales: Un paciente-caso se definió como aquel que presentó una recidiva de SCA y un paciente-control se definió como aquel que no presentó recidiva de SCA. Ambos grupos utilizaron ambulatoriamente clopidogrel debido al SCA previo. Como factor de riesgo se definió la utilización conjunta de omeprazol y clopidogrel ambulatoriamente. Resultados: Durante el estudio se formuló clopidogrel a 1.680 pacientes. En este grupo se identificaron 50 casos readmitidos con SCA y 76 controles. No se encontró asociación estadísticamente significativa entre el uso de clopidogrel-omeprazol y un mayor riesgo de reingreso hospitalario por SCA (OR: 1,05; IC 95%: 0,516-2,152; p = 0,8851). Conclusiones: En este pequeño grupo de pacientes con SCA previo, la utilización simultánea de clopidogrel con omeprazol no aumenta el riesgo de un reingreso hospitalario por recurrencia de este tipo de evento coronario.

Background: Infection by Helicobacter pylori is common and affects both genders at any age. The 13C-urea breath test is a widely used test for the diagnosis of this infection. However, multiple drugs used for the treatment of Helicobacter pylori infection symptoms have interactions with this breath test that generate false negative results. This observational study was to assess the potential interaction between almagate and the breath test. Methods: Thirty subjects on almagate therapy who underwent a breath test were included. If the result was negative, almagate was withdrawn for a month and the breath test was then repeated. Results: In general, 51.9 % of assessed subjects had a negative result after the first test, and 100 % of these also had a negative result after the second test. Conclusions: It was concluded that the use of almagate does not interfere in breath test results. These results provide a drug therapy option for the treatment of symptoms associated with Helicobacter pylori infection during the diagnostic process.

Background and purpose: Successful treatment of Helicobacter pylori infection causes not only eradication of pathogen, but also prevents the associated diseases such as peptic ulcer, gastric carcinoma and lymphoma. The aim of this study was to evaluate the efficacy of 7 days triple therapy as a lowest drug resistance, shortest duration and fewer numbers of drugs in children. Materials and Method: The target population was 22 children

Introduction: Extensive use of proton pump inhibitors (PPI) can result in an increased risk of drug interactions. Aged polypharmacy patients are a source of particular concern. A systematic electronic prescription (EP) review allows detection of potential drug - drug interactions. Material and methods: Retrospective, transversal, observational study: review of e-prescription orders received during 2015 in our community pharmacy. Results: 1186 EP dispensed to 164 patients (age 65.7±17.2), 52 patients in 71-80 range. 11.0±5.6 medicines per patient. 27% IBP EP with no approved indication. 77% EP used as gastroprotective agent. As far as omeprazole is concerned, risk of negative outcomes associated with medication (NOM) detected in 29 patients (30%), 15 of them taking the drug without approved indication. Most prevalent comorbidities: hypertension (n=81), dyslipidemia (n=61) and diabetes (n=36). Drugs responsible for potential interaction: acenocoumarol, iron, cyanocobalamin, escitalopram, benzodiazepines and clopidogrel. Discussion: 80% of omeprazole EP were dispensed to patients aged 61-90. Coupled with multimorbidity and polypharmacy, the duration of the treatment exceeded directions for use in most of the cases. Chronification and increase of NOM may be due to lack of an appropriate patient follow-up procedure. Many of the drugs responsible for omeprazole interactions were prescribed to treat most prevalent health problems. Thus, risk of NOM does not appear to depend on PPI appropriate indication. Conclusions: EP review let us to assess the risk of suffering from a NOM. Reviewing pharmacokinetic PPI interaction profile allows to depict the basics for a later intervention. During EP review, safety and necessity NOMs were recorded in similar percentages. Most relevant interactions found for omeprazole occur during metabolism of the drugs. [ABSTRACT FROM AUTHOR]

Gastroesophageal reflux disease is one of the most common gastrointestinal disorders affecting approximately 40% of the population worldwide. D-002 (beeswax alcohols) and omeprazole (OMP) present protective effects on experimental esophagitis induced by reflux. In this study, the effect of combined therapy D-002 + OMP on acute gastroesophageal reflux (GER) induced-esophagitis was evaluated. Rats were randomized into 5 groups: a negative control and 4 GER groups: a positive control, one D-002 (10 mg / kg), one OMP (5 mg / kg) and one combination (D-002 + OMP). The administration of monotherapies reduced moderately (48.91%) and significantly the ELI, while the combined therapy had a marked (76.05%) and significant inhibition compared with the positive control and with both monotherapies, respectively. Both, D-002 and OMP as well as combined therapy produced significant reductions in the MDA concentration in esophageal tissue (77.85, 48.62 and 66.45% inhibition, respectively) compared with the positive control, whereas no additional benefit of the combination was obtained compared with D-002 and OMP monotherapies. D-002 did not produce significant changes in the volume and acidity of gastric juice (GJ). OMP and the combined therapy did not change the volume of the GJ, although both reduced markedly (71.39%, 58.26%, respectively) and significantly the GJ acidity. In conclusion, the administration with single oral doses of D-002, OMP and the combined therapy exhibited a protective effect on GER induced-esophagitis in rats, being evident an additional beneficious effect of the combined therapy. [ABSTRACT FROM AUTHOR]

The interferon (IFN) production by rat thymus lymphocytes and the activity of IFN-induced 2′,5′-oligoadenylate synthetase (2′,5′-OA-synthetase) in these cells were stu­died at hypoacidity of gastric juice evoked by omeprazole injection and also at combined omeprazol and multiprobiotic “Apibact®” treatment. The IFN production by thymocytes of rats with hypoacidity of gastric juice was shown to increase by 2.5±1.2 times in comparison to control (intact animals), the 2′,5′-OAS activity decreased by 28±1.34%. Both the IFN production and enzyme activity were increased comparative to unstimulated cells in response to IFN inducers – phytohemagglutinin A (PHA) (20 µg/ml) and cycloferon (50 µg/ml) treatment in vitro. Administration of “Apibact®” in parallel with omeprazole administration, led to amplification of the PHA action on IFN production and 2′,5′-OAS activity in thymocytes. Probably, the IFN synthesis by thymocytes is stimulated under hypoacidity of gastric juice. It may be a result of activation of immune response to opportunistic microflora colonization of stomach. “Apibact®” exhibit immunomodulatory properties, amplifying the ability of thymocytes to synthesize IFN in response to exoge­nous stimulation in rats with hypoacidity of gastric juice.