Drugs used in therapy of Peptic ulcer, Gastroesophageal reflux disease and Inflammatory bowel disease

Abstract

Considerable advances in understanding the pathogenesis and in the treatment of acid-peptic conditions have occurred, culminating in the discovery of Helicobacter pylory and proton pump inhibitors. We now know that eradication of H. pylory effectively promotes healing of peptic ulcers and prevents their recurrence in most cases. Proton pump inhibitors have become the drugs of choice in promoting healing from erosive esophagitis and peptic ulcer disease because of their ability to nearly completely suppress acid production. Although several clinical challenges still need to be met in this area, it is reasonable to conclude that the battle against the ravages of gastric acid is finally turning in our favor. More progress has been made in specific diarrheal disease, such as inflammatory bowel disease, where advances in understanding the pathophysiology have led to an increasingly rational approach to therapy. This paper presents the drugs used in therapy of peptic ulcer, gastroesophageal reflux disease and inflammatory bowel disease in current clinical practice, by giving the main information about their mechanisms of action, pharmacokinetic characteristics, side-effects and interactions with other drugs. Finally, the prospective of new research, which is expected to improve the therapy of these diseases, is shown.

Napredak u razumevanju patogeneze i terapiji acido-peptičkih oboljenja kulminirao je otkrićem Helicobacter pylory i inhibitora protonske pumpe. Danas je poznato da eradikacija H. pylory efikasno pomaže zarašćivanju peptičkog ulkusa i sprečava vraćanje bolesti u većini slučajeva. Inhibitori protonske pumpe su lekovi izbora u zarašćivanju erozivnog ezofagitisa i peptičkog ulkusa zbog njihove sposobnosti da skoro u potpunosti inhibiraju produkciju kiseline. Mada ima još nekoliko otvorenih pitanja iz ove oblasti, opravdano je zaključiti da smo bitku protiv razarajućeg dejstva želudačne kiseline najzad dobili.Veliki korak je učinjen i u racionalnoj terapiji specifičnog oblika dijareje, inflamatorne bolesti creva zbog otkrivanja novih elemenata patofiziologije bolesti. Ovaj rad prikazuje lekove koji se koriste u savremenoj terapiji peptičkog ulkusa, gastroezofagealne refluksne bolesti i inflamatorne bolesti creva, dajući osnovne informacije o njihovim mehanizmima dejstva, farmakokinetičkim karakteristikama, neželjenim efektima i interakcijama sa drugim lekovima. Na kraju, prikazana je i perspektiva novih istraživanja, od kojih se očekuje da dovedu do daljeg unapređenja terapije ovih oboljenja.