Omeprazole: Inhibiting the Final Common Pathway to Acid Secretion - The Acid Pump

Omeprazole is the first agent in a new therapeutic advance classthe proton or acid pump inhibitors which represents a significant therapeuticadvance in the treatment of acid related diseases. Omeprazole reduces gastricacid secretion at its source – the acid pump of the parietal cell, thereby offeringprecise and consistent clinical effects. Omeprazole once daily has been shown toheal over 80% of duodenal ulcers within two weeks and over 95% within four weeksIn gastric ulcer, the healing rates are up to 80% within four weeks and 96% withineight weeks. More patients are free from symptoms earlier on omeprazole therapythan with the H2 receptor antagonists. Omeprazole is also effective in healing andsymptom relief even where prolonged H2 receptor antagonist therapy has beenunsuccessful. Omeprnzole has been shown in clinical trials to be the first consistentlyeffective treatment of erosive/ulcerative reflux esophagitis. Complete healingis achieved in the majority of patients and symptom relief is rapid. In clinicaltrials with 20 mg once daily, over 70% of patients healed within four weeks and upto 85% healed within eight weeks. Also. patients with erosive/ulcerative refluxesophagitis resistant to three months or more of treatment with full therapeuticdoses of H2 receptor antagonists have shown significant benefit, with healingrates of 49% within four weeks and 73% within eight weeks of therapy withomcprazole. The rare Zollinger-Ellison syndrome has been difficult to treat in thepast due to the massive hypersecretion of gastric acid Omeprazole has provedhighly effective in this syndrome, being well tolerated by patients who have receivedmore than five years of continuous treatment with daily oral doses up to 160 mg. Insummary, in extensive clinical trials omeprazole has been shown to be highlyeffective in the treatment of duodenal and gastric ulcers, erosive/ulcerative refluxesophagitis and Zollinger-Ellison syndrome. Omeprazole is well tolerated and iswithout any established side effects when used for short periods. It remains to beestablished whether H2 blockers still represent the best available therapy for acutetreatment of peptic disorders, and whether maintenance therapy is best achievedwith H2 blockers or with proton pump blockers