Proton Pump Inhibitors

Back to chemistry basics. What’s a proton? A hydrogen and it’s positively charged. So when we look at H+, that would be a proton. To calculate pH, you’re looking at the molarity which is the concentration of the [H+]. A proton pump is an integral membrane protein that moves protons across a cell membrane, mitochondrion, or other organelle.  For more info: H⁺/K⁺ ATPase (gastric proton pump)

Proton pump inhibitors work on the stomach and instead of working on the histamine receptors, they work on the proton pump. This is especially useful with GERD which is a fancy medical term for heart burn. When someone is having heart burn, the acid is not being blocked by the esophageal sphincter valve and it’s going up. Historically, people suffered a lot and the proton pump inhibitors were a major breakthrough. It not only relieved symptoms but also prevented esophageal cancer (because all the acid in the esophagus causes dysplasia of the cells). This also works down the tract and promote the healing of an ulcer but also takes 6-8 weeks.

Examples: These are all easy to recognize as they all end in -prazole.

• Esomeprazole (Nexium) – p.o.
• Lansoprazole (Prevacid) – p.o.
• Dexlansoprazole (Dexilant) – p.o.
• Omeprazole (Prilosec) – p.o.
• Rabeprazole (Aciphex) – p.o.
• Pantaprozole (Protonix) – p.o., inj

For these to work the best it can, the drug needs to enter the proton pump the best it can. These are administered just once a day, so the best timing is to be dosed 30 minutes before a meal. The person consumes it 30 minutes before a meal, it goes into the blood stream, and when the person consumes the meal, the pump starts working. When the pump is working, that’s when the drug gets into the pump and quite literally “clogs up” the pump so it doesn’t work for 24 hours.

Recap

• Prevents acid secretion
• Prevents gastro esophageal reflux disease (GERD)
• Promotes healing of ulcers