Omeprazole or pantoprazole is more colorful. What is the difference between omeprazole and pantoprazole? Zasosuvannya for lіtnіh people

ІPP, or іngіbіtorі proton pompі, be referred to the group pharmacological preparations, Vikoristovuvanih in therapy of shlunk pathologies. Lykarski will quickly learn the symptoms, provoked by the overwhelming hydrochloric acid. The most effective representatives of IPP: Rabeprazole, Omeprazole, Lansoprazole, Pantoprazole, etc. Stink vikoristovyu in the warehouse complex treatment of different types of gastritis and inferior ears. Before the signs of proton pump ingibitories, the gastroenterologist vivchaє results of laboratory and instrumental dosages. With the prescribed doses and the significant triviality of the patient's treatment, the patient's health status and health history are evident.

Omeprazole is the best representative of the Ingibitoriv group of proton pump

Features of pharmacological preparations

Dovgy hour for pH adjustment shlunk juice vikoristovuvalsya antacids. When people get into the body, they enter into a cheeky reaction s hydrochloric acid. Confirmed as a result of neutral products and herbal tract with cutaneous intestinal emptying. Ale have antacids є serious shortages:

• the visibility of the trivial therapeutic activities;
• nezdatn_st vlivati ​​on the main cause of the disease.

To that, the synthesis of the first representative of the proton pump () was caused by a breakthrough in the therapy of diseases and gastritis. If antacids additionally help to reduce the level of vitamins in hydrochloric acid, then ІPP pereshkojaє її purification. This allows you to unify the development of people with dyspeptic disorders - over-excess gas, nudoti, blues, ovens and sour haircuts... The insane dignity of the proton pump is the ability to maximize therapeutic concentration in the systemic blood flow. Only after 15-20 years, the steam cells of the slunk will repair the new hydrochloric acid.

To activate the representatives of the IPP in the herbal tract, the following parts are required:

• best nada lіkuvalnu dіu Rabeprazole;
• We trust ourselves to Volodya Pantoprazole.

Є at the Ingibitors of the proton pump and the power behind. For example, if penetrated into the intestinal tract, all IPPs will induce purging of acidic acid and 85% more.

Pre-treatment: “When choosing a drug for the treatment of gastritis or malignant ears, the patient is sensitive to the individual sensitivity of the patient to the dialectical speech of the proton form singer. Vona show up to do it boldly - navit with a recent intake of tablets, the pH of the slurry juice drops sharply. Such a concentration of acid will begin approximately in a year, and then insist on improving the self-esteem of people. "

Diya of likarsky zasobiv in the body of people

ІPP - tse the successors of Likarsky zasobіv. Therapeutic activity is to repair only by attaching a proton to them in the gastrointestinal tract. The active form of the preparation is injected without a precession on the enzyme, which is considered for the viroblasting of hydrochloric acid. The proton pump Іngіbіtori not immediately fix political powers And only in the world is the accumulation of basic spoluks in tissues and conversions into sulfenamides. The liquidity of the decrease in the amount of hydrochloric acid may vary depending on the type of preparation.

Ale such a growth is possible only in the first days of the Victory IPP. In the process of conducting clinical events, it has been brought to the fore, through a period of time spent on the proton pump, the therapeutic efficiency of the test. We can make a lot of things similar chemical warehouse lykarsky zasob_v. All IPPs are admitted to substitutions for the lost benzimidazole and approved as a result of a weak acid reaction. For activation in the small intestine, the preparations are repaired by injecting the slurry into the lining of the cells of the mucous membrane. Tse vidbuvaєtsya offensive rank:

• IPP penetrate into the tubules of parietal cells, transforming into tetracyclic sulfenamide;
• a proton pump to avenge the cysteine ​​receptor, which is called sulfenamide behind other disulfide compounds;
• start to strangle the dyu (H +, K +) -ATPases that are rosted on the apical membranes of the green cells;
• to cope with, and then to recline the transfer of protons into the empty slunk.

By attaching (H +, K +) -ATPase, the purging of hydrochloric acid and clitins of the slurry shell of the slurry becomes uncomfortable. Carrying out antisecretory therapy is shown to patients with any forms of gastritis, to reduce acidity. The price is necessary for fast regeneration of tissue tissues - the main cause of pain in epigastric disease.

Porada: “It is not possible to miss the IPP reception or to re-privatize the love. Obov'yazkovyu mind and quick regeneration of tissue є post-presence of drugs in the body of people. Firing and cicatrization of the proton pump through the spike of the ears to the ear to the ear of the proton pump.

Ingibitories of the proton pump with pantoprazole for antibiotics

All views of the proton pump

Gastroenterologists are victorious for the treatment of slunk-intestinal pathologies five representatives of the proton pump, where one type of one common talk is used. If one IPP is ineffective, the drug replaces the other. On the shelves of pharmacies, there is a kind of antisecretory view of the impossibility of structural analogies of the Russian and foreign vyrobnitstva. The stench can smell of mothers of serious prices of opinion, unaffected by the same dose and number of capsules.

Vibrating mіzh analogs of one of the representatives of the IPP, the gastroenterologist does not recommend the patient more expensive drug. It’s not a matter of zinuvachuvati lіkarya in be-such a corista - so it’s overwhelming in large quantities is true. For example, the Russian drug omeprazole has є analogues:

• Indian Omez;
• Ultop virobnytva Slovenia.

Bagato patients do not see any difference, they take drugs, so as the stench exhibit approximately the same therapeutic effect. Ale at the doyakykh people oduzhannya nastane send a course lіkuvannya Ultopu. I’ll explain it’s not just yakistu diyuchy speech, Ale і additional additional Ingredients, vicories for the formulation of capsules and tablets. Proton pump blockers individual entrance at prescribed doses and triviality of course treatment.

lansoprazole

The bioavailability of a representative of the IPP group is close to 90%. Mechanism of development of lansoprazole is derived from other drugs in the design of radicals, which will prevent anti-secretory effect. Lykarskiy zasіb formulation of the establishment of specific immunoglobulins to Helicobacter pylori. As a result, the growth of gram-negative bacteria is successful in attracting. Tsey ingibitor of the proton pump does not disturb any inflow on the motility of the intestinal tract. Prior to structural analogs lansoprazole are used: Lancid, Epikur, lanzap.

pantoprazole

On the day of the last IPP, Pantoprazole can take a trivial hour in the therapy of gastritis and malignant ears. This method does not provoke development side-by-side... Pantoprazole stagnates just as the pH value of the slurry juice, as it does not infuse its therapeutic efficacy. Proton pump insanity - the number of diagnosed flares on the course of the course. Pantoprazole is dispensed with virobniks in capsules for oral administration and injections. Nayvidomish structural analogs of the drug - Krosatsid, controllers, Nolpaza.

rabeprazole

The anti-razorine drug is derived from omeprazole as a perennial and imidazole acid, which allows rabeprazole to more effectively bind protons and calories. The proton pump engine is released from the capsules, covered by the intestinal-corrosive membrane. When you buy rabeprazole, you get more ears through the month, when you get a cob of it. Gastroenterologists include the drug in the therapeutic regimen of gastritis provoked by Helicobacter pylori. Before structural analogs of rabeprazole, there are: Zolispan, Khairabezol, Bereta.

esomeprazole

The presence of only one S-isomer Esomeprazole is not so rapidly metabolized by hepatocytes, as it is the reaction of the proton pump. The drug is in the systemic blood flow at the maximum therapeutic concentration for a trivial hour. lykuvalna diya Esomeprazole is nearly 15 years old, which is the most common indicator of the middle of all IPPs. Naybіlsh vіdomі analogs of the tsy drug - Emanera, Nexium.

Crossings of the Ingibitoriv proton pump

Vyrobniki vypuskayut ingibitorii proton pump in viglyadі capsules, tablets, solutions for parenteral administration. Ін'єкційні preparations vikoristovuyutsya in case of aggravated shlunkovy pathologies, if it is necessary to quickly reduce the amount of hydrochloric acid. Diyuchі speeches of solid lykarsky forms cover with a meaty shell. It is necessary to get rid of the proton pump from the infusion of aggressive shlunk juice. Without a sheath, the preparation is generally used quickly, without having to stir up any kind of therapeutic infusion.

It is obvious that such a person will not be able to drink IPP in the small intestine and will be able to get a lot of speech in the middle. Such a way of penetration allows the appearance of lykarsk people in the maximum therapeutic power. Prior to the unspecified merits of the drugs, the following are included:

• shvidke and effectively usuneniya stoves and pains in the epigastric period in patients with the development of the blending of slurry juice and herbal enzymes;
• more trivial and intensive reduction of the purge of hydrochloric acid in porous with antacids lykarskiy zasobamiі H2-receptor antagonists;
• finding the effectiveness in the therapy of patients with gastroduodenitis, cranial ailment, and two-fingered intestines;
• the appearance of a short period of time and an insignificant nirkovy clearence;
• absorption in the small intestine;
• high level of activation at low pH values.

Ingibitori proton pump - drugs that gastroenterologists always include in the therapeutic regimen, even when laboratory dosages in patients of boule Helicobacter pylori. Tsі gramnegativnіbacterії often cause development of virazok and gastritis. Pathogenic microorganisms get sick with jiguties, behind the addition of such a stench.

Dodano: 23.04.2017

One of the most frequent gastroenterological pathological conditions is the change of hydrochloric acid in the slurry juice (or hyperacidity). Such a camp is the basis of the firing of the slunk or 12-palate intestine, as well as the formation of spiraling lesions in them. The acidity can be adjusted due to non-infectious reasons - systematic and / or severe stress and inappropriate consumption, as well as due to the colonization of mucous slurry due to the bacteriological cause of Helicobacter pylori.

First and foremost, and in another way, for the treatment of hyperacid diseases, the preparations of the IPP group are used, so that the proton pump is used. The most popular brands of the group є Omeprazene (omeprazole) and pantoprazole (pantoprazole). The mechanism of the preparation is the same - the stench will bring the H + / K + -ATPase enzyme (or a "proton pump"), which will make sure that the slunk is empty. With a decrease in the amount of water, a decrease in the concentration of hydrochloric acid in the slurry and the normalization of the acidity of the slurry juice is increased. As a result, the mucous membrane is gradually absorbed, and it can be increasingly seen.

So what is the difference between Omeprazene and pantoprazole?

Ratio characteristics of the preparation - IPP 1 and 2 generation.

* To be a bit of active speech, how to reach the moment of your life (in a specific way - to the parietal cells of the slunk).

** Tobto yak strongly the drug can reduce the pathologically altered acidity of slunk juice.

*** For an hour, for a yake, the speech is active to spend half of your therapeutic concentration.

summary

Omeprazole is more viable as an antisecretory drug (4 times stronger than pantoprazole). Omeprazole starts to decrease for a little while, but the concentration of active speech decreases more quickly.

Pantoprazole is a big "m'yakim" drug. The beginning of the first few days of the year was reversed by the introduction of the secretion of hydrochloric acid. Ale at the same hour, pantoprazole increased the therapeutic concentration in the blood. I have an antimicrobial effect, which is mute for omeprazole. Pantoprazole is a very widespread drug.

It is not possible to see a leader with two preparations, since the skin of them has its own passages and shortcomings. In one cool vipad for the patient there will be a short Omeprazene, in the first - Pantaprozolo. The exact definition of the drug is due to the individual characteristics of the disease and may be qualified by the approval of the gastroenterologist. Whenever there is an opportunity to consult with a Fakhivtsy, you can use a spontaneous self-help drug to get rid of the intestinal information.

The usual practice of a gastroenterologist is able to provide food without food, tied from the stasis of likars, and even in this hour a lot of preparations are used.

Some of them are similar in pharmacological effect and mechanism of the process, іnsha - є as an alternative to expensive medications, drugs, vidsutnіm for sale, or we know about virobnіstva. Often, drug users are told to choose between pantoprazole and omeprazole.

Rosberemosya, Pantoprazole or Omeprazole - which is more beautiful and the stench wins.

Shlunkovy is from a group of ingibitors of the enzyme system, which is called a proton pump (or a proton pump).

In pharmacies, they are sold under the names:

The average batch of cich preparations is 200 - 300 rubles.

Also, cheap capsules of the Russian virobnitstva are released, the price does not exceed 70 rubles.

Blocking the activity of enzymes, bringing in the production of hydrochloric acid. As a result, the traumatic inflow of increased acidity on the slime of the slurry slides will speed up, and the erosive and inflamed ears will appear on them.

Infused into the microflora of organs of etching, bringing the life of Helicobacter pylori. With the acceptance of anti-microbial diseases, the effectiveness of the anti-Helicobacter poultry is efficacious.

Shvidko assimilates the symptoms of dyspepsia - bile in epigastria, oven, sour haircut. The positive dynamics will appear after 5 days after receiving the drug on the cob.

Such power is in control of cinnamon Omeprazole in the treatment of gastroenterological pathologies, which is superseded by the hypersecretory function of the parietal cells of the slunk:

• reflux esophageal ailment;
• virazok and erozii, localized in the slunker and intestine;
• gastropathies, accumulated by the intake of medications;
• Zollinger-Ellison syndrome.

Individuals with hypersensitivity to the components of the capsules, їх vikoristovuvati is not possible. For children, vaginal women and one-year-old mothers, the drug is contraindicated through the side effects(Vinyatok - Omez, who is safe for the cich categories of patients pidtverdzhennym klinicheskogo dosledzhennyy).

Appreciation in case of stove disease and nirok is possible only for the recommendation of a doctor through an aggressive inflow on the central organ.

The course of treatment is trivial, in the form of the established diagnosis from 1 to 2 months.

pantoprazole

In pharmacies, performances under the names:

• Nolpaza;
• controllers.

The price of the packing will be repaired from 200 rubles.

Also є proton pump. Dispensed in tablets.

Mechanism of action similar to omeprazole. Zakhischaє mucous shell of the shlunk from an aggressive acidic middle ground. Pereshkojaє the development is accelerated, I will cut through the spirals. Increasing the effectiveness of anti-chelikobacter therapy.

The ability to stay in the diagnosis and in the dosage regimen is effective. The style of polish will begin to be recognized in 7 days after a cob of love.

Symptoms of dyspepsia, such as bile in the shlunk, are known from the first days of taking pills.

From the іnіhіbіtorіv drug dіії іnіhіbіtorіv the drug is dіії іnіhіbіtіvіyu sіykistu.

Clinical tests confirm the effectiveness of the medication with:

• Zollinger-Ellison syndrome;
• lіkuvanni zagostreni і prophylaxis of malignant ailments;
• erosive gastritis, amalgamated with gastrotoxicity of lymphocytes, for example, analgesics and hormones;
• gastroesophageal reflux ailment.

Brutal respect! With dyspepsia of a neurotic character, it is not possible to accept it.

Іnshih mated to zasosuvannya є:

The drug is taken once a day, in trivial courses (1-2 months).

In case of pathologies that have accumulated the life of the bacteria, Helicobacter pyloria, vicorisation in combination with anti-microbial for special schemes.

Likewise

Some of the basic characteristics of the drugs and conditions, in which omeprazole is derived from pantoprazole.

Vipusku form

Pantoprazole is dispensed only in tablets for administration in the middle.

Omeprazole can be dispensed in different forms vipusku, including powder for vseredin, capsules and capsules. That is why the children and the children have more possibilities when they find the children more difficult and hospitable.

partnership

Omeprazole is a medication based on it and is cheaper than pantoprazole.

Found cheap capsules can be bought for 35 rubles. Road options cost 250 rubles. The minimum price of a course pack with pantoprazole is 380 rubles.

The difference between pantoprazole and Omeprazole has a lot of reasons to be found in this parameter.

sweetness

It is necessary to assess the quality of the preparation according to the virobnik and the price.

Vysokoy yakistiu volodyut Nolpazaі controllers, revenge Pantoprazole. Oh, I am safe and the effectiveness of the certification by the number of key vintages.

Omeprazole has a good quality in the middle price category ( Losek, Omez, Ultop).

Omeprazole of cheap virobniks, the rate of which does not change 100 rubles. It is unlikely that one can boast of the high quality of syruvina and does not infuse organism into the head "filters" - nirok and stoves.

sucking

The overflow of indications is similar in both cases - the pathology of the intestine and the slunk, which is supervised by the supermath synthesis of hydrochloric acid.

Obmezhennya to accept similar. indications:

Consistency with the smallest tags

Pantoprazole і Omeprazole styki before interaction with other drugs.

Vinatok - atazanavir. You cannot take pantoprazole for an hour.

Bezpeka in case of alcohol consumption with other medications lie in the form of trivial therapy. Judge from vidguk_v patients, serious heritage did not mean it.

bitter appearances

Offended by the leads to catch the endocrine system - in case of trivial stagnation, they cause prolactin and destroy the mineral exchange. Most sparing in general є Pantoprazole.

When both drugs are taken, dyspeptic symptoms may appear - style breakdown, pain and discomfort in the abdomen, boredom and blues. I will look at the fact that the offense to the medication poddajutsya metabolism in the liver, the powerful development of side effects from the side of the body. However, there are also short-hour changes and minus messages. The offense caused the creation of an allergic reaction.

p_dvodimo pidbags

It is unambiguous to say which one of the preparations is more beautiful. All to deposit from the virobnik and price category. cheap drugs you cannot boast of a high quality, baked goods, classy viprobuds and versatile likars' forms. And the axis of Omeprazole of the middle price segment of the nitrocha is not worse than pantoprazole, but in order to turn it over.

Omeprazole і Pantoprazole, vіdmіnnіst:

1. Omeprazole permits for mothers and children (Omez).
2. Pantoprazole is contraindicated for treatment with atazanavir.

In any case, the decision about those who are different in a particular type is guilty of accepting the license.

This information is designated for the health care professionals and pharmaceuticals. Patients are not guilty of vicarious information in the capacity of medical advice.

Pantoprazole in the therapy of acid-deposit diseases

E.P. Yakovenko, A. V. Yakovenko, Yu. V. Illarionova, N.A. Agafonova, S.A. Lavrent'eva, A.N. Ivanov,
A.S. Pryanishnikova, L.P. Krasnolobova
Department of Gastroenterology, Faculty of Advanced Medical Studies
"Russian National Pre-Slidnytsky Medical University named after M. I. Pirogov"
Ministry of Health and Social Development of Russia, Moscow

The proton pump inhibitor (IPP) pantoprazole blocks the basal and stimulates the secretion of hydrochloric acid into the slurry by driving it to the H + / K + -ATPase enzyme. According to the literature and the results of recent reports, the antisecretory effect of pantoprazole can be determined from such IPPs. the main by the authorities pantoprazole є in the absence of a metabolic process with liver diseases taken overnight, the drug does not accumulate in the body; Presentation of the current scheme of therapy with pantoprazole injections for GERH, Helicobacter pylori infection, gastropathy, association with non-steroidal antiapharyngeal diseases, for the prevention of gastrointestinal treatment.

Key words: acid deposits, proton pump, pantoprazole, lykarsky vzamodia

Pantoprazole, proton pump inhibitor (PPI), blocks basal and stimulated secretion of hydrochloric acid in the stomach by inhibiting the H + / K + -ATPase. According to the literature data and own research results, antisecretory effect of pantoprazole is comparable with that of other PPIs. The main distinguishing features of pantoprazole are the lack of interaction with simultaneously taken drugs, the drug does not accumulate in the body, dose adjustment for elderly patients with the presence of renal and hepatic failure is not required, and its effect does not depend on the genetically determined metabolic rate in the liver. Modern medical regimens with pantoprazole for the treatment of gastroesophageal reflux disease, Helicobacter pylori infection, NSAID-associated gastropathy, and for the prevention and treatment of stress ulcers and gastroduodenal bleeding are presented.

Key words: acid-related diseases, proton pump inhibitors, pantoprazole, drug-drug interactions

Acid-dependent sickness (ACD), in the pathogenesis of which is the role of hydrochloric acid, is the most common in the practice of a gastroenterologist and is more common in 30% of the population of Russia. The main ones are gastroesophageal reflux ailments (GERH), peptides of the slunk and two-fingered intestines, gastropathy, viclicia with the ioma of non-steroidal anti-apical diseases (NPZZ-depletion), gastropathy chronic gastritis, Pancreatitis. In this hour, it is important to develop KZZ therapy without vicious proton pump (IPP) ingibitoria, to the group of which include omeprazole, esomeprazole, pantoprazole, lansoprazole and rabeprazole.

All IPPs that are obsolete to benzimidazole and are developed by radicals in pyridine and benzimidazole rings, as well as in other pharmacokinetic and pharmacodynamic powers. At the same hour, all IPP may have a similar mechanism of action - the building is brought into the basal layer and stimulated by the secretion of hydrochloric acid into the slurry by means of a gate driven to the enzyme H + / K + -ATPase (either protonally pumped), on the localized surface Н + / К + -ATPase is a key enzyme in the transport system, as it will take part in the transferred ions from the cytoplasm of the parietal cells to the enlightenment of the secretory tubules and to exchange them in the space from the space. In the given C1, according to the concentration gradation, it is also possible to enter the secretion of the secretory tubules, de and to obtain the approval of hydrochloric acid. IPP, є with a weak base, accumulate in the acidic middle of the secretory tubules near the proton pump. The protonation of the atom of the pyridine ring of the IPP molecule and the transformation of the acid into the active word - sulfenamide, which covalently calls with one or more cysteine ​​surpluses of the catalytic (but) subunit As a result of the IPP, there is a change in the rate of the secretion of hydrochloric acid, which is easy for a longer period of time, at least an hour of circulation in the blood plasma, and for the renewal of acidic products, the synthesis of new proton is required. IPPs are developed behind a small number of links with cysteine ​​on the catalytic α-subunit of the proton pump. With a whole lot of pantoprazole, it specifically calls for a dilenkoy, but it includes n'th transmembrane segments of the α-subunit of the proton pump, as well as cysteine ​​822, which can be easily displaced into the deep transport domain of the proton pump, which is not readily available for zdatnye usuvati proton pump. At the connection with cyme, pantoprazole can be used more trivially, lower and lower IPP.

For pantoprazole, the characteristic features of the temporalis and stable bioavailability (77%), when the maximum acid-suppressive effect is achieved from the first dose of the drug, At the same time, it is more optimal to reach the secretion of hydrochloric acid when taking 40 mg of the drug, but not when taking it at the same dose in the evening. According to the results of additional monitoring of the intragastric pH acid depressant effect, pantoprazole at a dose of 40 mg appears to be more vivid, less than omeprazole at a dose of 20 mg, which is similar to that in the case of a lower dose of lansoprazole of 30 mg / day. At the same hour, the antisecretory effect of pantoprazole was almost completely unrecognizable with enteral or intravenous administration at a dose of 40 mg.

We carried out a preliminary dosage of acid-suppressive effects of equivalent doses of original preparations of esomeprazole (Nexium, Astra Zeneca) - 20 mg, rabeprazole (Pariet, Janssen-Cilag) - 20 mg; by patients with virazkovy ailments of two-fingered intestines. The results are presented in the tables.

Table. Estimation of acid-depressive effect of esomeprazole, rabeprazole and pantoprazole

Thus, the acid-depressant effect of pantoprazole (Controltoku) is quite unrecognizable from the original IPPs - esomeprazole and rabeprazole.

In a critical plan, a person who has an acid-depressive effect with overly significant powers, such as to get rid of an IPP vibration, is a low level of mode due to low-risk diseases, the appearance of such a cumulative effective Stopping neobhіdna for profіlaktiki i terapії stresovih erozivno-virazkovih urazhen i krovotech of verhnіh vіddіlіv shlunkovo-kishkovogo tract, Poperedjennia kіslotoaspіratsіonnogo syndrome pid hour anestezії and takozh for lіkuvannya patsієntіv for yakih nepriynyatny enteralny Way treatment (nudota, blyuvota, dіareya stenosis stravohodu , the gatekeeper, the ruin of the work and the in.).

As a result of the metabolism in the liver due to the participation of enzymes in the system and cytochrome P450, the antihypertensives CYP2C19 and CYP3A4, in connection with the beginning of the pharmacological activity At the same time, it means that pantoprazole in some cases with lower IPPs has a lower affinity to cich isoenzymes, but also a lower range of likars' interactions. At ryadі farmakologіchnih i klіnіchnih doslіdzhen shown scho pantoprazole (Kontrolok) not vzaєmodіє of antacids antipіrinom, kofeїnom, klopіdogrelem, oral contraceptives, etanolom, glіbeklamіdom, levothyroxine, metoprolol, pіroksikamom, teofіlіnom, amoksitsilіnom, klaritromіtsinom, diclofenac, naproxen, diazepam, karbamazepіnom , digoxin, nifedepine, warfarin, cyclosporine, tacrolimus and other drugs. Dani about likarsky relations turned out to be extremely important in the case of cardiological ailments, as they can take antiaggregants, anticoagulants, and other drugs in the first place for an hour. It has been shown that in the middle of the patients, who had suffered myocardial infarction, one-hour reception of clopidogrel and any IPP, pantoprazole, often increased the frequency of the development of repeated infarction in the early period of the thermoplastic infarction.

Pantoprazole (Controloc) for administration as omeprazole and ezomeprazole is not trimmed in the body after receiving repeated doses. So, after intravenous administration of pantoprazole at a dose of 30 mg / add for 5 days, the pharmacokinetic indicators were determined to be reasonable as they were eliminated from intravenous administration of the first dose. With pharmacokinetic dosages of pantoprazole with oral administration in doses from 10 to 80 mg, and with intravenous administration in doses of 240 mg, the syrovatz blood has little linear character. The power of pantoprazole often appears from those, which occur during the intravenous administration of omeprazole, when the dose of which in the same range of the area is not consumed in a crooked "concentration-hour" (AUC) Krіm of viyavilosya scho vіdmіnnostі in farmakokіnetitsі pantoprazole in osіb of upovіlnenim i priskorenim metabolіzmom, yaky otsіnyuєtsya for genetichno determіnovanoї aktivnostі іzofermentu 5 mefenіtoіn-4 "gіdroksilazi not toil whether yakoї klіnіchnoї znachuschostі. Vazhlivoyu vlastivіstyu pantoprazole (Kontroloku), yak zdіysnyuє yogo in singing situations with the drug Vibor in the therapy of KZZ, є there is a need for a correction of the dose for patients with a kidney disease, as well as for the lack of liver and liver disease.

In this hour of accumulation, there is a great classroom dosage of vicorian pantoprazole in KZZ therapy. Є to finish the publications, assigned to the evaluation of the effectiveness of the classical antigelicobacter therapy, 500 mg of the lower dose of antigelicobacter therapy, in which pantoprazole is included in a dose of 40 mg 2 times in addition to the dose in the same dose 2 times for two doses stretching 7-14 days. The incidence of Helicobacterpylori (HP) irradiation during the period of consumer therapy, which included pantoprazole, varied between 71-93.8% during the ITT (intention-to-treat) -analysis (in the form of all therapy patients), according to the protocol 86 -100% in case of PP (reg-protocol) -analysis (in the case of patients, who have finished the follow-up to the protocol). With a whole group of authors, it was shown that, with vicious emergency therapy, she included pantoprazole, the frequency of the treatment of the bullet was more effective, the lower the scheme of therapy, which included omeprazole. resistance of the pathogen to the antibacterial component of the vicorian scheme of consumer therapy. In addition, as a matter of fact, the effectiveness of anti-chelikobacter therapy is developed in case of new clinical manifestations of YR-infection and H. pylori strains. As a result of a number of tests carried out, it is shown that H. pylori strains are positive for cytokinesis-associased gene (CagA), often appear in patients with a viral two-fingered intestine, it is easier to negatively develop a part of the syndrome.

The results of the numerical monitoring confirmed the effectiveness of pantoprazole in the treatment and treatment of the remission of the errosive and non-erosive GERD. So, in the course of randomized sublinear cases, or when it is very critical, GERD was set up, but in case of erosive treatment of GERD (stage II and III according to Savary-Miller), the effectiveness of pantoprazole at a dose of 40 mg / day at a dose of 40 mg / day for the same lansoprazole 30 mg / day and esomeprazole 40 mg / day, there was an increase in the amount of effective ranitidine at a dose of 300 mg / dobu or famotidine 40 mg / day. Similar results have been eliminated in case of vicorian pantoprazole in the prevention of recurrences of GERKH. Thus, it has been shown that pantoprazole at a dose of 20 or 40 mg / add for 12-24 months after developing the development of recurrent reflux esophagitis in a large number of patients, in those on the background of the previously carried out therapy for the long lasting disease. At the same time in prophylactic therapy, the efficacy of 20 and 40 mg of pantoprazole was not significantly increased.

pantoprazole znayshov wider sucking in therapy and prevention of refinery-associated gastropathies. So, in a randomized randomized dosage D. Olteanu і spіvavt. The boulevard was installed, after 4 months of therapy for cicatricial treatment of refineries-associative treatments, which were diagnosed in 87% of patients, who took pantoprazole at a dose of 40 mg / day and in the middle of 75% took omeprazole at a dose of 20 mg / day. After 8 tendencies, the wounds were healed in all patients, who were treated with IPP. Visoka efektivnіst pantoprazole in dozі 40 mg / day profіlaktitsі NPZP-asotsіyovanih gastropathy been viewed pіdtverdzhena patsієntami have yakih bulo dosyagnuto rubtsyuvannya ranіshe іsnuyuchih virazok i at the time cob profіlaktichnoї terapії at endoskopіchnomu doslіdzhennі viyavlyalasya normal abo gіperemovana mucous Ilya Obolonkov of nayavnіstyu less then 5 vognischevih petechiae in verhnіh in the slunk-intestinal tract. In addition, there is a minimum of one factor in the development of erosive-viral lesions, up to the number of gastritis or malignant disease in the anamnesis, the presence of one or more refineries, taking corticosteroids and anti-inflammatory drugs, abduction vik that in. ...

Parenteral introduction of ІPP as a general-viscous component of therapy, directed to the prevention of recurrent bleeding from the slopes of the slunk and two-fingered intestine for endoscopic hemostasis. In the number of pre-adolescents, it was established that the internal administration of pantoprazole reduced the frequency of recurrent bleeding after 48 and 72 years, the number of transfusions after 72 years, and mortality after 14 days.

The analysis of the literature and the results of the most recent reports allow for the development of the optimal therapy regimens for the main CPZ with pantoprazole.

non-erosive coat of arms... Pantoprazole should be given 20 mg 1 time per dose (30 minutes before drinking) for 4-8 months with the onset of reception in the "on vimoga" mode.

erosive COAT OF ARMS... Pantoprazole is taken 40 mg 1 time per dose (30 minutes before drinking) for 4-8 months with the transition to additional therapy, as transferring the drug to the drug at a dose of 20 mg / day for 6-12 months and in the "on-demand" at a dose of 20 mg / day.

modern schemes Heradication of H. pylori includes IPP + 2 antibiotics, in most cases - in conjunction with the drug bismuth. Yak IPP can be used with vicoristany pantoprazole at a dose of 40 mg 2 times per dose. Below is a series of schemes, with the recognized healing of H. pylori 80%.

The scheme of therapy of the first line, as a rule, є Chotirohcomponent is propagated in the given hour.

empirical therapy: Pantoprazole (Controloc) 40 mg + amoxicilin 1000 mg + clarithromicin 500 mg + tinidazole 500 mg or metronidazole 500 mg. All preparations take two for 10-14 days.

last therapy: Pantoprazole (Controloc) 40 mg + amoxicilin 1000 mg two-by-one for another 5-7 days, then pantoprazole (Controloc) 40 mg + clarithromicin 500 mg + tini-dazole 500 mg and metronidazole 500 mg two for another 5-7 days. Triviality of therapy - 10-14 days.

bismuth-containing quadrotherapy: Pantoprazole 40 mg 2 times per dob + bismuth subcitrate 240 mg + tetracycline hydrochloride 500 mg (offense 4 times per dob) + metronidazole 500 mg abo tinidazole 500 mg 3 times per dob for 10, ale more 14 days. Our scheme: pantoprazole (Controloc) 40 mg + amoxicilin 1000 mg + clarithromicin 500 mg + bismuth subcitrate 240 mg. All preparations take two for 10-14 days.

In case of ineffectiveness of high-grade methods of radical therapy, use the reserve schemes: IPP + levofloxacin 500 mg 1 time for dobu + amoxicilin 1000 mg 2 times for dobu 14 days or IPP + rifabutin 150 mg + amoxicilin 1000 mg 2 times

In case of acute ailments, asocyovanoy with H. pylori, the triviality of taken pantoprazole 40 mg / day should be taken with duodenal infection 2-4, with shlunkovaya - 4-8 times.

For the prevention of the development of stress strains, pantoprazole (Controlok) is prescribed internally at 40 mg of skin for 12 years before the stabilization of the sick person and transfer to the Interal-ve harchuvannya. At the junction of the sour, sour-toassociated reduction of the mucous membrane of the shlunk is formed for 24 years from the cob stressful situation Parenteral administration to Controloku should be immediately sent to the patient in the intensive therapy ward, and during planned operations for the prevention of acid-aspiracy syndrome - before any hour of anesthesia.

In the world of stabilization, I will begin parenteral administration of the drug and transfer the sick person to enteral administration of pantoprazole according to the scheme "leave the drug + persha tablet to the drug". In connection with the relative pharmacokinetic and pharmacodynamic powers of the IPP (for example, the maximum acid-depressive effect is attainable in the case of vicious pantoprazole with the first dose of the drug, and ostomeprazole - for 7-dose peroxide)

In the middle, for cicatricial stress erosive-virazkovyh urazheniya, a choteritization course of IPP therapy is required.

In such a rank, in Denmark, pantoprazole (Controlok) is one of the most effective IPPs, which can be used in the lіkuvannі KZZ. At the connection with both the efficiency of the drug and the efficiency of the drug in the same doses, as well as the secondary It is especially significant for a patient who is sick, who can take a lot of medicines at once, and also for patients who are vicious to take drugs in a wide range of therapeutic activities. In such vipadki, the perevag needs to be given pantoprazole, for which the development of lykarsky relations is minimal. Besides, the presence of given to the drug lykarsky forms of yak for enteral, as well as for internal storage Allowing the expansion is shown until the end of the day and without the need for a safe transition from parenteral to oral administration.

literature

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For a quote: Shulpekova Yu.O. Pantoprazole: one of the most powerful ones // RMZ. 2011. No. 28. S. 1 782

Today, medicine is uncomfortable to develop without proton pump (IPP) ingibitories, which are widely used in gastroenterology, cardiology, pulmonology, rheumatology. IPP, bezperechno, brought their efficacy in the treatment of acid-oleaginous problems and acceleration before preparations of the other classes.

The five main IPPs in the practice of a drug are tse omeprazole, esomeprazole, rabeprazole, lansoprazole and pantoprazole.
IPP is developed according to the speed and triviality of the antisecretory activity, especially the metabolism, the form of the drink (in capsules, tablets, coated with an enteric coating - MAPS (Multiple Unit Pellet System)), injected for the injection
When I am taken in the middle of the IPP, I wake up and soak in the small intestine. Diyucha speech accumulates in zones with the lowest pH values; in the area of ​​secretory tubules of parietal cells, de pH = 1 ÷ 2, the concentration of IPP increases by 1000 times in blood. In cich minds, protonation of IPP occurs, and the stench is transformed into an active form - sulfenamide. Remaining irreversibly linked to the cysteine ​​overload of H + / K + -ATPase (proton pump) and blocking function. The price of supra-consumption is attributed to the basal and stimulated secretion of hydrochloric acid (just as a matter of nature). Acid products are introduced into the world by introducing new synthesized H + / K + -ATPase molecules into the membrane of parietal cells.
The range of pH, when the activation of the IPP is seen, the enumeration of the peculiarities of the molecule. The rate of activation of pantoprazole when the pH is adjusted to 3 drops = 4, and it is practical to increase it at pH = 4. Activation of the largest IPPs is trivial at a higher pH: for example, the rate of coverage of sulfenamide izomeprazole at pH = 4.9. The particularity of allowing the viewing of pantoprazole is a drug that is selective for the parietal cells of the slunk, in the range of pH that can reach the lowest values. Pharmaco-dynamics of pantoprazole Ochikuyuut, but not blockade of H + / K + -ATPase and H + / Na + -ATPase and blood cells - bilious epithelium, hematoencephalic bar, intestinal epithelium, neoplasm clitin, osteoclasts, and also infused onto organelles with an acidic middle - lysosomes, neurosecretory granules and endosomes, de pH = 4.5-5.0. The vibrancy of the process of transferring to the mens the number of non-existent appearances, especially in the case of trivial stasis.
IPPs are metabolized in liver microsomes for the participation of P450 subunits - CYP2C9, CYP2C19, CYP2D6 and CYP3A4. With a lot of stench in the steppe, the oxidative activity of CYP enzymes is adjusted. The most significant is the interaction between CYP2C19 and CYP3A4.
According to the results of the in vitro dosage, in the middle of the fifth most often IPP pantoprazole is deposited in the smallest world, CYP2C19 and the largest world - CYP3A4. Omeprazole, esomeprazole, rabeprazole, and pantoprazole are among the variability of the CYP2C19 function for lansoprazole; for the strength of the infusion on CYP3A4 for pantoprazole follow omeprazole, esomeprazole, rabeprazole, lansoprazole.
The CYP2C19 gene develops polymorphically, injecting into the therapeutic effect of IPP. CYP2C19 takes its part in the metabolism of significant quantities of drug preparations, for that it is very practical to infuse IPP into the P450 subunit. Pantoprazole has the lowest potential for interaction with drugs, detoxification of some of the counterparts for the participation of CYP2C19.
CYP3A4 also plays an important role in the metabolism of liquids; її activity іstotno varіyuє. The subunit of P450 is also exported to the apical membrane of the intestinal food, which can be added to the accessibility of the skin, making its additions to the "first pass effect".
In the middle of the drug IPP pantoprazole, it lowers the affinity to the cytochrome P450 system, and decreases immediately during the I phase of detoxification due to the participation of CYP2C19 and CYP3A4 in the prototype of the 2-sulfate phase;
In doslіdzhennyah for participating health dobrovoltsіv i patsієntіv of rіznoyu patologієyu not viyavleno znachuschih vzaєmodіy mіzh pantoprazole i antacids, digoxin, diazepam, diclofenac, etanolom, fenіtoїnom, glіbenklamіdom, karbamazepіnom, kofeїnom, metoprolol, naproxen, nіfedipіnom, pіroksikamom, teofіlіnom, oral contraceptives, R -varfarin, clarithromycin, cyclosporine, tacrolimus, sodium levothyroxine. With a one-hour intake of pantoprazole and coumarin anticoagulants, a higher INR control is required. The combination of pantoprazole with methotrexate is insufficiently vaccinated.
Pantoprazole of presentation on the Russian market by the drug Nolpaza® (company KRKA, Slovenia) in the form of tablets, in a critical enterosolubil shell. The stench is small for the size and spice in the corystuvanny.
The pharmacokinetics of pantoprazole are characterized by fast moisture absorption from the intestinal tract; bioavailability in case of reception in the middle to become 77% and not to accumulate in the middle of the income. The hour of reaching the maximum concentration of the drug in the plasma (Cmax) in the middle becomes 2-2.5 years. With regular intake of pantoprazole, the value of Cmax should be kept permanent. The indicator of the area from the pharmacokinetic curve "concentration-hour" (AUC) and Cmax also does not lie in the reception area. The AUC represents the amount of the drug, which reached the target of the proton pump molecules, and the proportion of the antisecretory. For pantoprazole, the AUC becomes 9.93 mmol / LH, it is possible to adjust the AUC for 40 mg of esomeprazole. Basic form for intravenous administration of pantoprazole.
Pantoprazole is 98% bound by plasma proteins. The period of time (T1 / 2) becomes 1 hour. 80% of metabolites are metabolized by nirkami, 20% - by zhivchyu. In case of chronic nircovian deficiency (among those patients who are on hemodialysis), the drug does not need to change doses. In case of important liver disease, T1 / 2 increases up to 3-6 years, AUC grows 3-5 times, Cmax - 1.3 times in cases of healthy individuals, in connection with which it is recommended to add a dose of pantoprazole, but I do not overtake 20 mg. Patients of a kidnapped person are considered to have an increase in AUC and Cmax, which is not less important.
At a higher pH range, at any rate of activation of the drug, which is associated with pantoprazole from the other IPPs, it is more trivial for the The result is that the period of administration of the drug is not correlated with the trivial antisecretory effect, and when the intake of pantoprazole is applied, the secretion is renewed after 46 hours.
It is imperative to provide data on the effectiveness and safety of pantoprazole for materials of recent years and look back at the most recent years.
Efficacy of pantoprazole in GERCH. IPPs mintly recommended themselves as preparations of the first line in the GERKh line for an equally important and important interruption. The preparations change the amount of shlunkovy secretion, increase the pH of the shlunkovy vstu, overshkodzhayuchi shlunkovuyu hydrochloric acid, components of gum and herbal enzymes.
The recommended dose of pantoprazole in case of reflux ailments, in the presence of a swelling of the esophagus and sensitivity to licking, to become 20-80 mg per dob (in one or two priyomi). A dose of 20 mg is more often found in more mild forms of GERD. The dose of 40 mg in the form of a small and important ref-lux-esophage is determined in terms of efficiency with omeprazole, lansoprazole, and esomeprazole.
Supplementary therapy with pantoprazole at a dose of 20-40 mg for up to two rocky cases of obstruction-wrapping and recurrent reflux-esophagitis in a large number of ailments.
You can recommend and take 20-40 mg of pantoprazole "per vimogu" - in case of an emergency or shortcuts. In robots Scholten and spivavt. It has been shown that the consumption of pantoprazole at a dose of 20 mg or for ezomeprazole at a dose of 20 mg is equally effective as a trivial, susceptible drug of non-steroid herpes and stage of the A-B esophage in Los Angeles. On aphrodisiac pantoprazole, the incidence of the oven is less.
Pantoprazole in a dose of 40 mg will provide sufficient control of symptoms of non-reflux, and in most cases it is possible to use esomeprazole.
Looking around Lehmann FS. and Beglinger C. Some robots of the last few years have presented data on the high efficiency of pantoprazole in various forms of GERCH and the good tolerance of the drug. On the lіkuvannya tsim drug, the frequency of the slowing down and the quality of life of the ailments change with reflux ailment.
The effectiveness of pantoprazole is due to the genetically determined activity of CYP2C19 - S-mefenitoin 4'-hydroxylase. In the robot Sheu B.S. і spіvavt. 240 patients with reflux-esophagitis stages C and D according to the Los Angeles Classification were treated with pantoprazole at a dose of 40 mg for a long time. Tim is ailing, for those who have reached the point of being able to relieve the symptoms of reflux (n = 200), it is recommended to continue drinking with pantoprazole 40 mg "for vimoga" by stretching out to the rock. In the case of the CYP2C19 genotype, we have seen “quick”, “intermediate” and “general metabolizers”. An effective type of therapy "for vimogu" was seen in "general metabolizers": the stench was taken in the middle 11.5 tablets per month (versus 16.3 for "intermediate" and 18.6 for "quick metabolizers", p<0,05) .
In patients with over-excess weight, pantoprazole is prescribed in a "sub-dose" - 40 mg 2 times and the results of reflux esophageal treatment will be further reduced and it will be possible to switch to the regime of reception "on vimoga". The efficiency of the increased dose is especially favored by the "quick metabolizers".
In two randomized subordinate patients, pre-admission blockers assessed the rate of prescription for a clinical disease - the reduction of symptoms of non-ferrous reflux disease and reflux-esophage of the 1st stage of the Savary-Miller generation - on the other side nizatidina 150 mg 2 times per dob and ranitidine 150 mg 2 times per dob). Pre-treatment was carried out in parallel groups, the frequency of symptoms was assessed on a 4-point scale. At the time of treatment with pantoprazole, a significantly larger proportion of patients was considered to be stolen for the next day of treatment (39% versus 14.5% in the group were treated with nizatidin, p<0,01). Достоверная разница в пропорции пациентов, которых изжога перестала беспокоить, сохранялась в течение первой недели, а затем препараты показали равную эффективность .
COAT OF ARMS is not easy to supervise and sleep. In a cohort of patients, an injection of pantoprazole was injected into the self-feeling of patients with symptoms of reflux ailment and obstructive apnea. The patients trimmed 40 mg of pantoprazole for 3 months. In the course of the therapy, there is an increase in the number of symptoms: decrease in sleepiness in the afternoon (p = 0.002), in the absence of awakening in reflux symptoms (p<0,0001), выраженности храпа (р=0,03) .
In the last robots, 84% of the patients from GERH did not suffer from an overwhelming mass of sleep, regained sleep: reflux symptoms in the back and in the wounded years, difficult sleep, distracted sleep, wounded weakness. On the lіkuvannya pantoprazole stretching in the middle of 1.4 months, 75% of those who are more mature have a little bit of sleepiness; at the most significant symptoms of reflux at night.
Modolell I. and spivavt., Krim assessments of key signs of sleep deprivation in children with ailments (coldness, apnea, drowsiness), were carried out polysomnographically before sleep. Clinical and polysomnographic effect on aphids with pantoprazole susceptibility in 78% of patients.
Pantoprazole is known to be used in anesthesia. One of the most promising accelerated anesthesia is the aspiration of shlunk juice; pH instead of the slurry 2.5 and 25 ml (0.4 ml / kg weight) In a subordinate patient, it is shown that pantoprazole at a dose of 40 mg is more effective, less than prokinetic erithromicin at a dose of 250 mg, in a reduced risk of aspirin accelerated (with a one-time intake of 1 year, as long as
Nutrition about efficiency and safety of IPP in children, lack of adequate immunization (lack of evidence has been accumulated). To that, in the instructions, before the appointment of pantoprazole, it is possible to figuruvati the child. However, in the pediatric drug, the prescriptions are given. With the introduction of pharmacokinetics and without pantoprazole in an additional dose of 20-40 mg in children 6-16 years old, who suffer from GERD, they do not feel the taint of cumulative pantoprazole and are not registered serious non-essential cases. In two robots, the effectiveness and safety of different doses of the drug in the GERH test were introduced in children from 1 month to 5 years, including prematurity. It has shown good tolerance to pantoprazole, suppression of symptoms and start of erosive changes to the strain before the 8th period of treatment. The frequency of non-essential symptoms did not increase with the dosage adjustments.
Pantoprazole in lycuvanne ailments, functional dyspepsia, lykarskoy gastropathy. In case of malarial ailments of the slunk and 12-palate intestine, pantoprazole is consumed in a dose of 40 mg 1-2 times per dose. At the warehouse of radioactive therapy (as a rule, in combination with metronidazole, clarithromycin and amoxicilin), without an advance delay of antibiotics, pantoprazole at a dose of 40 mg, 2 times for an additional to-treat). A useful regimen for the treatment of pantoprazole is not to compromise on the effectiveness of one that includes omeprazole and abolansoprazole.
The Malaysian pre-adolescents evaluated the frequency of radiation, the tolerance and the sickness of patients before the use of antihelcobacterium therapy with pantoprazole. Among the participants in the boule, there were 26 patients with malignant ailments and 165 with non-viral dyspepsia, infected with H. pylori. For 7 days, ailments were treated with a standard anti-Helicobacter therapy with pantoprazole 40 mg 2 times per day. An effective type of radiation was assessed for an additional dichal urease test. 84.4% of the ailments completed the protocol following the treatment, the frequency of illnesses was 71.2%. During the period of treatment, non-essential manifestations were fixed in 68 (42.5%) participants: dyspepsia, inferiority, spoilage, hanging on shkirі. At the same time, the appearance was not declared as serious. Authors of the newsletter about even good tolerance of the unnecessary radical scheme with pantoprazole.
Pantoprazole in a good dose of 20 mg is generally effective in the prevention of gastropathy, association with the use of non-steroidal anti-inflammatory drugs (NSAP). For lykuvannya lykarskoy erosive-vyrazkovyh urozheniya slunk and 12-paloi intestine pantoprazole priznachayut 40 mg 1-2 times per dob.
In a sub-baseline blind placebo-controlled patient with a huge number of participants, 800 people have increased the effectiveness of pantoprazole in the control of symptoms in patients with NSAIDs and assessed in the infusion of older alcoholics (such as those who are smoking Pantoprazole is primed at a dose of 20 mg per dose, the triviality of therapy is 4 times. The variability of dyspeptic symptoms of Bula was even lower in the group, pantoprazole was treated (p<0,0001); эффект препарата стал наиболее отчетливым через 7 дней лечения, независимо от влияния основных факторов риска .
In case of high shlunkovaya hypersecretion, including Zollinger-Ellison syndrome, pantoprazole should be prescribed in doses ranging from 80 to 160-240 mg per dose, either internally; The triviality of a taste is taken individually.
Pantoprazole is non-baked in case of trivial zastosuvanny. The British presenters have had the effectiveness and tolerance of 5-rivulets of pantoprazole in 150 patients who suffer from acid-fallow entrapment (on virazkovy ailments or anti-reflux disease) With aggravated sickness, the dose of pantoprazole became 80 mg, with ineffectiveness lasting 12 months, the dose was increased to 120 mg, and when aggravated, it was reduced to 40 mg. Among the number of those assessed such parameters as histological changes, gastrin levels in the blood, the population of enterochromatic clitins in the mucous membranes. A fraction of patients in the stantik remission after the end of one rock went down 82%, two rockets - 75%, three rockets - 72%, some rockets - 70%, five rockets - 68%. The duration of the remission in reflux ailment did not occur due to the infection of H. pylori. In the process of elimination, the level of syrovatous gastrin increased by 1.5-2 times (especially high values ​​were indicated in case of heliobacteriosis). In some people with ailments, epizodic gastrinosis is> 500 ng / l. In patients infected with H. pylori, there is a decrease in the rate of gastritis in the antrum and growth - in the slunk, with the appearance of a sign of atrophy. The number of enterochromatic cells in the antrum changed insignificantly for 5 years, but in the first place the slunk changed by about a third. Neglect-tel-ni appearances, madly tied with the reception of pantoprazole, fixed in 4 patients. Thus, the tolerance of the trivial administration of pantoprazole in the whole form of such in case of receiving the first IPP.
Pantoprazole and clopidogrel. In the last few years, the state government received food about lykarsku vzamodiy ІPP and clopidogrel, as supervising changes in drug and prophylactic antiaggregants, the development of scholasticity to arterial thrombosis. It is not easy to recognize IPP as such a disease for the prevention of lycopene gastropathy and bleeding.
In addition, the results of a cohort retrospective diagnosis were used for the triviality, in which cases were analyzed in 16 690 patients, who underwent stenting of coronary arteries and took away the therapy (98 for chronic diseases). to lіkuvannya. In terms of the primary end point, the frequency of "great heart disease" (stroke, transient ischemic attack from hospitalization, coronary heart disease, coronary revascularization, death of heart disease) was estimated. In a cohort of ailments, only clopidogrel were eliminated, the frequency of "great heart-vascular pod_y" was 17.9%, in a cohort, clopidogrel and IPP were eliminated - 25% , 39-1.64, p<0,0001). В данной работе не обнаружено существенных различий риска при приеме отдельных ИПП .
The prodrug clopidogrel is converted into an active metabolite due to the participation of the liver CYP2C19. A slight increase in IPP caused the activity of the P450 subunit, which can also change the clinical and prophylactic effect of clotting disease: supervising the increased reactivity of thrombocytes to increase So, omeprazole reduces the AUC of the active metabolite of clopidogrel by 50%. You can also use these mechanisms injected into the IPP for the activity of the bug.
According to the recommendations of the All-Russian Scientific Society of Cardiologists (VNOK), patients with stable manifestations of atherothrombosis are susceptible to atherothrombosis, if they want a key value in relation to the modality of the IPP, but it is not recommended that there is a residual At the congress of the European Society of Cardiologists in Serpenny 2011 in Paris Boule, new recommendations were presented for the treatment of ACS without the second ST segment, but for the use of GCS, it is recommended that new antiplatelet drugs be used. Likuvannya klopidogrel primed only in quiet drops, if the sign of the first two preparations is uncomfortable. If we are sick, if we accept antiplatelet therapy, it is shown that there is a disease of the proton pump (not omeprazole) with the presence of mucus-intestinal hemorrhage or acute intestinal ailment, as well as a factor in the presence of a disease.
It means that the injection of pantoprazole on the activity of CYP2C19 is significantly weaker, lower in the case of other IPPs. Yogo neutrality in relation to the relationship to clopidogrel was demonstrated in the population predictions for the type of "vipad-control", which included 13 636 ailments, such as for myocardial infarction, the recommendations for taking an antiplatelet agent were recommended. Pre-admission patients had a frequency of recurrent or repeated infarction in the interval of 90 days during the period of vipisk from the hospital to the hospital with the IPP reception. Statistical analysis showing that one-hour (in the interval of 30 days in advance) with the IPP of association with the development of the risk of recurrent / repeated myocardial infarction (reported chance 1.27, 957% DI 1.03-1.57) There was no connection with the ІPP reception more than 30 days before the repeated coronary podії. With a stratified analysis, it was shown that taking pantoprazole did not induce a prophylactic clopidogrel and did not induce a recurrent / repeated myocardial infarction (incidence 95% chance) 1.02, 1.02, 1.0
For a larger deceased patient in combination with clopidogrel, omeprazole and pantoprazole, 4 randomized placebo controls were performed with a re-designed design; 282 healthy volunteers took part in them. Klopidogrel was prescribed in a navantazhuvalnoy dose of 300 mg, then an additional dose of 75 mg per dob, omeprazole 80 mg once an hour (dosage 1); time with an interval of 12 hours (until 2). There was also an effect of adjusting the dose of clopidogrel up to 600 mg (navantazhuvalnaya) and 150 mg (supplementary) (up to 3) and in conjunction with pantoprazole (in a dose of 80 mg) (up to 4). Previously, it was shown that the use of omeprazole resulted in a decrease in the area of ​​the pharmacokinetic curve (AUC) for the active metabolism of clopidogrel, as well as increased platelet aggregation in the presence of adenosine diphosphate reactivity, Panto-prazol is not infused into pharmacodynamics and clopidogrel effect.
Vivchennya vzaєmodija clopidogrel and pantoprazole in a subdosing dose was assigned to the same randomized dosage with a redesigned design. Twenty healthy volunteers took clopidogrel (600 mg - navantazhvalny dose і 75 mg per additional dose) and pantoprazole (80 mg per additional dose). Pantoprazole was prescribed one hour with clopidogrel, for example, at 8 or 12 years. Before the procedure of randomization, only clopidogrel were trimmed with a stretch. Using different methods to assess the function of thrombocytes at different time points. Bulo has shown that pantoprazole in high doses is not infused into the pharmacodynamic defects of clopidogrel, right in the reception regimen.
In such a rank, pantoprazole (Nolpaza®) is characterized by a high efficiency in the treatment of acid-fallen illnesses, as well as the efficiency of the most recent IPPs, it is good to be tolerated in case of trivial stagnation.
Visoka selectivity of pH-mediated activation of pantoprazole to transfer a systemic drug to men. The price of nutritional support for special training sessions.
The drug is baked in lithium; no contraindications for severe liver pathology and nirok.
The insanely challenging pantoprazole is a low potential for intercourse with other drugs, which is especially important in the treatment of young patients, as it is possible to take some "drugs" in the same corridor. In ailments like taking clopidogrel, pantoprazole has recommended itself as a good measure, but not injected into the antiplatelet agent.

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