Inhibidores de la bomba de protones: el impacto en la salud cognitiva de los adultos mayores / Proton pump inhibitors: the impact on cognitive health in older adults

RESUMEN 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.

ABSTRACT 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 [βA] 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.

A unique formulation of sodium bicarbonate buffered pantoprazole powder for oral suspension: perspectives from an active controlled cross-over bioequivalence study

Background:The aim was determining bioequivalence between pantoprazole buffered powder for oral suspension and pantoprazole enteric coated tablets under fasting conditions in healthy volunteers.Methods:In randomized cross-over study, participants were administered a single oral dose of pantoprazole powder as suspension 40 mg (sodium bicarbonate as buffer) or one enteric coated tablet of pantoprazole 40 mg, with240�ml of water as per the randomization schedule in each study period. Blood samples were collected at pre-dose and at 0.33, 0.67, 1, 1.33, 1.67, 2, 2.33, 2.67, 3, 3.33, 3.67, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 12, 14, 16and 24hours post-dose. Plasmaconcentration of pantoprazole was determined with LC-MS and various pharmacokinetic parameters like Cmax, AUC0-t, AUC0-inf were compared between test and reference groups.Results:Amongst 41 subjects, Cmax(3752.4�84.6 vs. 3521.7�99.5 ng/ml)was achieved higher in less Tmaxtime (1 (0.28) vs. 2.3 (0.83) hrs)with test drug as compared to reference drug. The ratios of geometric least square mean and its 90% confidence interval on log transformed Cmax, AUC0-t and AUC0-inffor pantoprazole fall within the acceptance criteria of 80% to 125%. No adverse events were observed.Conclusions:Pantoprazole powder for oral suspension 40 mg (sodium bicarbonate as buffer) was well tolerated and bioequivalent with pantoprazole enteric coated tablets IP 40 mg in terms of rate and extent of absorption under fasting conditions. At same time, the shift in AUC to the left with reduction in Tmaxwith the new formulation is suggestive of faster rate of absorption.

Pharmacokinetics and pharmacodynamics of (S)-pantoprazole sodium enteric-coated tablets in healthy subjects / 中国临床药理学与治疗学

AIM: To evaluate the pharmacokinetics and pharmacodynamics of (S)-pantoprazole sodium enteric-coated tablets in healthy subjects by using pantoprazole sodium enteric-coated tablets as a control drug. METHODS: Thirty healthy Chinese subjects were enrolled in a randomized, open and positive control trial. The subjects were given 20 and 40 mg (S)-pantoprazole sodium enteric-coated tablets and 40 mg pantoprazole sodium enteric-coated tablets, respectively. The concentration of (S)-pantoprazole in the human plasma was determined by LC-MS/MS and the pharmacokinetic parameters were calculated by WinNonlin 6.4 software. The intragastric pH was monitored for 24 hours. The dose-effect relationship of drugs was evaluated. RESULTS: The main pharmacokinetic parameters of (S)-pantoprazole after single administration of 20 and 40 mg (S)-pantoprazole sodium and 40 mg pantoprazole sodium enteric-coated tablets were as follows: The Cmax were (1 635±410), (2 756±1 024) and (1 536±615) ng/mL, the t1/2 were (1.41±0.31), (1.55±0.64) and (1.35±0.22) h, the AUC0-t were (3 623±1 322), (7 383±3 785) and (3 276±1 302) h•ng•mL-1; The main pharmacokinetic parameters of multiple administration were as follows: The Cmax were (1 704±239), (3 297±743) and (1 832±557) ng/mL, the t1/2 were (1.41±0.40), (1.58±0.64) and (1.45±0.22) h, the AUC0-t were (3 587±1 040), (8 189±3 399) and (3 878±1 272) h•ng•mL-1. After the treatment, the time of pH>4.0 as a percentage of total time (%) after single administration were (32.98±10.7)%, (45.37±9.61)% and (32.63±14.63)%; and the time of pH>4.0 as a percentage of total time (%) after multiple administration were (45.12±11.97)%, (50.76±10.63)% and (41.67±7.1)%. CONCLUSION: Healthy subjects have linear kinetic characteristics of (S)-pantoprazole after single and multiple administrations, and the 40 mg (S)-pantoprazole sodium group has better efficacy than other dose groups. Healthy subjects were well tolerated.

Enzymatically Synthesized Ph-Responsive Ipn For In-Situ Release Of Pantoprazole Sodium

Objective: This study involves the synthesis of Gum tragacanth (gt) based interpenetrating polymer network (ipn) and its utilization for sustained release of anti-ulcerative drug i.e. pantoprazole sodium. Methods: IPN was synthesized from Gum tragacanth, polyacrylic acid (gt-cl-paa) hydrogel. gt-cl-paa was kept in distilled water. Further, acryamide (aam) and methylmethacrylate (mma) was added and then kept for overnight. Later on, lipase and glutaraldehyde were added. Homopolymers and the unreacted monomers were removed using acetone. Synthesized IPN was dried at 50 °C for further study. Synthesized ipn was swelled in water and the drug was added to it. The drug was entrapped in the pores of the synthesized ipn and then drug release behavior was studied using uv-vis spectrophotometer. Results: Gt, paa and mma based crosslinked IPN were synthesized using lipase-glutaraldehyde as initiator-crosslinker system. The synthesized IPN was pH sensitive and possessed the desired swelling capacity required for the controlled and systematic liberation of pantoprazole sodium at 37 °C. The kinetic of drug release was studied and found that lateral diffusion (DL) of drug was higher as compared to the initial diffusion (DI). The prepared IPN can be used as prospective carrier for prolonged drug delivery. Conclusion: A novel pH sensitive and colon targeted IPN was synthesized. It acts as an effective device for the controlled release of drug pantoprazole sodium.

Esomeprazole and pantoprazole enhance the antiproliferative effects of cisplatin on the human neuroblastoma SH-SY5Y cell line

Background: Proton pump inhibitors (PPIs) largely used a drug to treat gastroesophageal disease such as gastric ulcers. Moreover, in recent years, several studies suggest that PPIs have an important anti-cancer effect in monotherapy and or combination with chemotherapy. The aim of this study was to investigate whether esomeprazole and pantoprazole exhibit anti-cancer effect alone or could enhance chemosensitivity on the human neuroblastoma cell line SH-SY5Y to cisplatin.Methods: The human neuroblastoma SH-SY5Y cells were cultured and treated with different concentrations of esomeprazole, pantoprazole, and cisplatin alone. Also, these cells exposed to cisplatin+ esomeprazole and cisplatin + pantoprazole combinations, respectively and incubated 24 h. The antiproliferative activities of the (PPIs) alone or in a combination of cisplatin was evaluated using the XTT colorimetric assay.Results: According to experimental data, neither PPIs showed no cytotoxicity on the human neuroblastoma cell line SH-SY5Y at all concentrations. However, when combined with cisplatin separately, they were found to have significant antiproliferative effects on the human neuroblastoma SH-SY5Y cell lines when compared to cell lines treated with cisplatin alone (p<0.05).Conclusions: Taken together, the inhibition of V-ATPase via esomeprazole and pantoprazole might enhance the chemosensitivity of cisplatin on the human neuroblastoma cell line SH-SY5Y. However, further studies are needed to be able to utilize PPIs in human neuroblastoma cells.

Prospects to the formation and control of potential dimer impurity E of pantoprazole sodium sesquihydrate / 药物分析学报

Pantoprazole sodium, a substituted benzimidazole derivative, is an irreversible proton pump inhibitor which is primarily used for the treatment of duodenal ulcers, gastric ulcers, and gastroesophageal reflux disease (GERD). The monographs of European Pharmacopoeia (Ph. Eur.) and United States Pharmaco-poeia (USP) specify six impurities, viz.; impurities A, B, C, D, E and F, respectively for its active phar-maceutical ingredient (API). The identification and synthesis of all impurities except impurity E are well described in the literature; however, there is no report related to impurity E. The prospects to the for-mation and controlling of impurity E up to ≤0.03％ in the synthesis of pantoprazole sodium sesquihydrate (PAN) were discussed in detail for the first time. The present work described the journey towards the successful development of an optimal preparation procedure of dimer impurity E. The most plausible mechanism involved in the formation of impurity E has been proposed.

Effect of pantoprazole in tumor bleeding prevention in patients with unresectable gastric cancer: a randomized,double-blind, placebo-controlled clinical trial / 中国综合临床

Objective To investigate the effects of pantoprazole treatment in the prevention of gastric tumor bleeding in patients with unresectable gastric cancer. Methods This study was a prospective double-blind,randomized,placebo-controlled trial. From January 2014 to July 2015,patients with gastric tumor bleeding in Xuzhou Cancer Hospital were included in this study. 131 cases of unresectable gastric cancer were randomly divided into two groups. In the experimental group,66 cases were taken pantoprazole 40 mg,1 time / d,and 65 cases in the control group were given placebo 40 mg and 1 time/ d. The course of treatment was 8 weeks. The differences in tumor bleeding,blood transfusion requirements and overall survival time between the two groups were observed during the follow-up period. Results The median follow-up time was 6. 5 ( 3. 3, 13. 2 ) months. Seven cases ( 10. 61%) in pantoprazole group had tumor bleeding, and 13 ( 20%) in the placebo group. There was no significant difference in cumulative risk of tumor bleeding between the two groups (Gray's test: P = 0. 426) . However,in the first 5 months of follow-up,the cumulative incidence of tumor bleeding in pantoprazole group was 0,lower than that in placebo group (9. 23%) (6/ 65) (Gray's test: P = 0. 039). There was no significant difference in blood transfusion requirement and overall survival between the two groups. No drug-related adverse reactions and bleeding related deaths occurred during the follow-up period. Conclusion Pantoprazole can not significantly reduce tumor bleeding in patients with unresectable gastric cancer.

Effect of Ulinastatin Combined with Pantoprazole on Inflammatory Factors and Gastrointestinal Tract in Patients Undergoing Cardiopulmonary Bypass Cardiac Surgery / 医药导报

Objective To investigate the effect of ulinastatin combined pantoprazole on inflammatory factors and gastrointestinal tract in patients undergoing cardiopulmonary bypass ( CBP) cardiac surgery. Methods A total of 200 patients who suffered rheumatic heart disease were scheduled for valve replacement surgery with CPB, were randomly divided into four groups:control group (CON),ulinastatin (UTI),pantoprazole groups (PTZ) and ulinastatin+pantoprazole groups(UTI+PTZ),50 cases in each group.Before CBP,group UTI was given ulinastatin 10 000 U·kg-1,group PTZ was given pantoprazole 40 mg,group UTI+PTZ was given ulinastatin 10 000 U·kg-1and pantoprazole 40 mg,group CON was given 0.9% sodium chloride soution.The gastric mucosa pHi and blood samples would be collected in all four groups at the preoperative (t1),CPB 30 min (t2),after CBP (t3),6 h after surgery (t4),24 h (t5) five time points.The IL-6 and TNF-α would be detected by enzyme linked immunosorbent (ELISA) method,and abdominal distension,abdominal pain,hematemesis,black and defecate occult blood test positive for digestive tract related complications would be collected after the surgery 1,2 days. Results The concentration of TNF-α and IL-6 at t2,t3, t4,t5were higher than those at t1in all four groups(P<0.05).Compared with CON group,the concentration of TNF-α and IL-6 at t2, t3,t4,t5in UTI,PTZ and UTI+PTZ group were significantly decreased (P<0.05).The concentration of TNF-α and IL-6 in UTI and UTI+PTZ group were better than in PTZ group.The pHi at t2,t3,t4was lower than that at t1in four groups(P<0.05),and pHi at t5 was obviously lower than that at t1in group CON (P<0.05).The pHi at t2,t3,t4in UTI,PTZ and UTI+PTZ group was higher than that in CON group ( P<0. 05), and pHi in UTI+PTZ group was better than that in UTI and PTZ group. The postoperative gastrointestinal complications in CON group were higher than those in UTI,PTZ and UTI+PTZ group (P<0.05). Conclusion Ulinastatin combined with pantoprazole for patients undergoing CPB heart surgery,can significantly reduce the release of TNF-α and IL-6、increase gastric pHi and reduce the incidence of gastrointestinal complications.

Clinical observation of acupuncture at Zhiyang (GV 9) points combined with pantoprazole for gastroesophageal reflux cough with damp-heat type / 中国针灸

<p><b>OBJECTIVE</b>On the basic treatment, to observed the effect difference between acupuncture at Zhiyang (GV 9) points combined with pantoprazole and simple pantoprazole for gastroesophageal reflux cough with damp-heat type.</p><p><b>METHODS</b>A total of 102 patients were randomly assigned into an observation group and a control group, 51 cases in each group. The patients in the two groups were given domperidone tablets (10 mg each time, 3 times a day). The patients in the control group were treated with pantoprazole capsule (40 mg each time, once a day). On the basis of the control group, the patients in the observation group were treated with Zhiyang (GV 9) points, once a day, 5 times a week. All the treatment was given for 8 weeks. The indexes were observed before and after treatment, including cough symptom at daytime and nighttime scores, TCM symptom (heartburn, acid regurgitation, chest pain, epigastric pain, throat discomfort) scores and quality of life scores of cough questionnaire in Leicester (physiological, psychological and social aspects). The clinical effects were compared.</p><p><b>RESULTS</b>After treatment, the daytime and nighttime cough scores, TCM symptom (heartburn, acid regurgitation, chest pain, epigastric pain, throat discomfort) scores were lower, and the quality of life scores of cough questionnaire in Leicester (physiological, psychological and social aspects) were higher than those before treatment in the two groups (all <0.05), with better results in the observation group (all <0.05). The total effective rate of the observation group was 94.1% (48/51), which was better than 80.4% (41/51) of the control group (<0.05).</p><p><b>CONCLUSION</b>On the basic treatment, acupuncture at Zhiyang (GV 9) points combined with pantoprazole can improve TCM symptoms, such as cough, of the patients with gastroesophageal reflux cough with damp-heat type, and improve their quality of life.</p>

The level of serum hypoxia-inducible factor-1α and the regulation of pantoprazole in patients with gouty arthritis / 中华风湿病学杂志

Objective To explore the level of serum hypoxia-inducible factor (HIF)-1α and the effect of pantoprazole on HIF-1α in patients with gouty arthritis.Methods Subjects were divided into acute gouty arthritis (group A),intermittent gouty arthritis (group B) and healthy controls (group C).Patients in group A were divided into mild (A1) and severe (A2) subgroups according to the severity of inflammation.Levels of serum HIF-1α in the three groups,and the levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in group A1 and group A2 were detected by enzyme-linked immunosorbent assay (ELISA).Patients in group A2 were randomly divided into three groups,saline 100 ml/twice a day,20％ pantoprazole 100 ml,twice a day and 40％ panto-prazole 100 ml,twice a day were administered respectively.After 7 days,the levels of serum HIF-1α were measured by ELISA.One-way analysis of variance (ANOVA) and two independent sample t test were conducted in this study.Results ① Levels of serum HIF-1α in group A [(48±13) ng/L] were significantly higher than those in group B [(40±12) ng/L,P＜0.01] and group C [(28±12) ng/L,F=29.838,P＜0.01].② Levels of serum HIF-1α [(56±10) ng/L],IL-1β [(51 ±13) ng/L] and TNF-α [(161 ±45) ng/L] in the experimental group A2 were higher than those in the experimental group A1 [HIF-1α:(42±11) ng/L,t=4.600,P＜0.01;IL-1β:(42±12) ng/L,t=2.552,P＜0.05;TNF-α:(122±34) ng/L,t=3.432,P＜0.01].③ Levels of HIF-1α [(26±6) ng/L],IL-1β [(23±4) ng/L],TNF-α [(92±6) ng/L] in the 40％ pantoprazole group were lower than those in 20％ pantoprazole 100 ml,twice a day group [HIF-1α:(33±4) ng/L];IL-1β:(30±5) ng/L;TNF-α:(102±7) ng/ L] and saline group [HIF-1α:(37±5) ng/L];IL-1β:(38±5) ng/L];TNF-α:(108±9) ng/L](all P＜0.05);Levels of HIF-1α,IL-1β and TNF-αin the 20％ pantoprazole group were lower than those in saline group (all P＜0.05).Conclusion ① HIF-1α may be one of the indicators of acute inflammation,which may reflect the degree of inflammation in patients with gout.② Pantoprazole can reduce the level of serum HIF-1α,IL-1β and TNF-α in patients with gouty arthritis,with a concentration dependent characterisit.

Analysis on the effect of pantoprazole and omeprazole in the treatment of gastric ulcer / 中国生化药物杂志

Objective To investigate and analyze the effect of pantoprazole and omeprazole in the treatment of gastric ulcer.Methods a total of 100 patients with gastric ulcer treated in Shizuishan First People's Hospital from January 2014 to June 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group.The control group was treated with omeprazole, and the experimental group was treated with pantoprazole.After taking one course of treatment, the clinical efficacy, treatment cost, eradication rate of Helicobacter pylori and recurrence rate of gastric ulcer were compared between the 2 groups.Results The total effective rate of the experimental group was 94%, which was significantly higher than that of the control group(72%), and the difference was statistically significant(P<0.05).After the corresponding treatment, the experimental group of 50 cases, Helicobacter pylori eradication rate was 72%, the recurrence rate of gastric ulcer was 12%.In the control group of 50 cases, the eradication rate of Helicobacter pylori was 52%, and the recurrence rate of gastric ulcer was 36%.As a result, the eradication rate of H.pylori in the experimental group was significantly higher than that in the control group.The cost of treatment in the control group was(499.78±74.81)yuan, and the treatment cost of the experimental group was(413.26±56.39)yuan.The treatment cost and gastric ulcer recurrence rate in the control group were significantly higher than those in the experimental group, with statistical difference(P<0.05).Conclusion Pantoprazole in the treatment of gastric ulcer is much better than omeprazole, high treatment efficiency, is the preferred drug for the treatment of gastric ulcer, after the treatment of gastric ulcer recurrence rate is low, the cost of treatment is low and high eradication rate, with the further promotion and application in clinic significance.

Clinical control study of omeprazole and pantoprazole in treatment of peptic ulcer hemorrhage / 药物评价研究

Objective To discuss the efficacy of omeprazole and pantoprazole in treatment of peptic ulcer hemorrhage.Methods 80 patients with peptic ulcer hemorrhage were selected,they were divided into two groups randomly.The observation group (41 cases) was given pantoprazole by intravenous drip.The control group (39 cases) was given omeprazole by intravenous drip.The efficacy and safety of omeprazole and pantoprazole in treatment of peptic ulcer hemorrhage was evaluated by efficacy,pH before and after treatment,bleeding time,hospitalization and bleeding volume,and adverse reaction during treatment.Results The effective rate was 92.7％ in the observation group and 89.7％ in the control group.There was no statistical significance on effective rate between two groups.But the excellent rate of observation group was higher than that of the control group (P ＜ 0.05).Before treatment,the gastric acid was acidic.There were no statistical significance on pH value between two groups.After treatment,the pH value was increased in two groups.The pH value of observation group was higher than that of the control group (P ＜ 0.05).The hospitalization,hemostasis time and bleeding volume was shorter than that of the control group (P ＜ 0.05).During treatment,the patients given pantoprazole had less adverse reaction (P ＜ 0.05).Conclusion Pantoprazole and omeprazole are suitable for treating peptic ulcer hemorrhage.But the antacid and hemostatic effect of pantoprazole was better with high safety.It was worthy of clinical application.

Psychological intervention method and effect analysis of pantoprazole sodium in the treatment of gastric ulcer / 中国生化药物杂志

Objective To explore the effect of psychological intervention with pantoprazole sodium in treatment of gastric ulcer. Methods A total of 80 patients with gastric ulcer from March 2015 to January 2017 were randomly divided into two groups, control group and observation group; Two groups were treated with pantoprazole sodium, the control group received conventional care, while the observation group was given psychological care.The rehabilitation of the two groups was observed and compared . Results The effective rate of observation group was 92.5％, significantly higher than that of the control group(77.5％); The satisfaction rate of the observation group was 97.5％, significantly higher than that of the control group 72.5％; the differences between the two groups were statistically significant.Conclusion The implementation of psychological nursing of pantoprazole in treatment of gastric ulcer in the process, can consolidate the curative effect to be fully reflected, help patients recover in time, and improve patient care for acceptance,it is worthy of reference.

Clinical study of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage / 药物评价研究

Objective Discuss the efficacy of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage.Methods Selecting 220 cases patients with gastrointestinal hemorrhage.They were divided into two groups randomly.The observation group (115 cases) was given pantoprazole combined with octreotide.The observation group (105 cases) was given pantoprazole.The efficacy of pantoprazole and octreotide in treatment of gastrointestinal hemorrhage was evaluated by efficacy,perioperative index,SF-36 scores and adverse reaction during 1 month follow-up.Results The effective rate of observation group was significantly higher than that of the control group (P ＜ 0.05).The bleeding time of observation group was shorter than that of control group (P ＜ 0.05).The blood transfusion of observation group was less than that of control group (P ＜ 0.05).The hemoglobin level and pH value observation group was higher than that of control group (P ＜ 0.05).Before treatment,there were no statistical significance on SF-36 scores.After 1 months treatment,physiological function,physical function and pain scores of observation group was higher than that of control group(P ＜ 0.05).During 1 months follow-up,there were no statistical significance on adverse reaction between two groups.Conclusion The pantoprazole combined with octreotide had a good therapeutic effect on gastrointestinal hemorrhage.It could stop bleeding quickly,reduce blood loss and blood transfusion.It could improve the quality of life and use safely with worthy of clinical use.

Effect of Pantoprazole on Skeletal Muscle Loss in a Mouse Model of Cancer Cachexia / 中山大学学报(医学科学版)

[Objective]To investigate the effect of pantoprazole on skeletal muscle wasting in cancer cachexia and the possible mechanism.[Methods]24 male BALB/c mice were randomly divided into control group(NN),cancer cachexia group(CC),pantrop?razole treatment group(PPI). The mice in CC and PPI were inoculated subcutaneously with mouse colon adenocarcinoma C26 cells to establish a model of cancer cachexia. The mice in PPI group were gavaged with 75 mg/kg pantoprazole dissolving in physiological saline,while those in NN and CC group were gavaged with 0.1 mL/10 g physiological saline. The mice were killed 12d after treatment. The weight of gastrocnemius and tumour and the size of tumour were measured. The morphological change of skeletal muscle were evalu?ated by the method of stain with hematoxylin and eosin(H&E). The levels of IL-6 and TNF-αin serum were tested by ELISA. qRT-PCR was used to assess the expression of mRNA of Myod1 and myf5 in skeletal muscle. The protein expressions of MuRF1,MAFBx, Myod1 and myf5 were measured by Western blot.[Results]Compared with CC group ,pantoprazole can increase the weight of mice and gastrocnemius(39.8% and 24.2%,respectively),cross section area(25.4%),levels of mRNA and protein of Myod1 and myf5(P<0.05),while the levels of IL-6 and TNF-αdecreased(30.7%and 18.9%,respectively),as well as the levels of protein ex?pression of MuRF1 and MAFBx(P < 0.05).[Conclusion]Pantoprazole can attenuate the wasting of skeletal muscle,the potential mechanism may be related to the inhibition of inflammatory factors and UPS ,and up-regulation of Myod1 and myf5.

Comparison of the efficacy of pantoprazole and omeprazole in the treatment of elderly patients with peptic ulcer / 中国基层医药

Objective To compare the clinical effect of pantoprazole and omeprazole in the treatment of elderly patients with peptic ulcer.Methods 200 patients with peptic ulcer were selected as study subjects,and they were randomly divided into two groups.The control group (100 cases) was orally given clarithromycin,amoxicillin and omeprazole triple therapy.The observation group (100 cases) was given clarithromycin,amoxicillin and pantoprazole triple therapy.The clinical efficacy,clinical symptoms disappeared time and adverse reactions occurred in the two groups were compared.Results The total effective rate of the observation group was 96％,which of the control group was 94％,the difference between two groups was not significant (x2 =0.421,P ＞ 0.05).The disappear time of abdominal pain,belching,burning and bleeding in the observation group after treatment were significantly shorter than those of the control group(t =35.545,56.680,98.896,61.109,all P ＜ 0.05).The incidence rate of adverse reaction of the observation group(5.0％) had no significant difference compared with the control group(7.0％) (x2 =0.354,P ＞ 0.05).Conclusion There is no significant difference in efficacy and safety between pantoprazole and omeprazole in the treatment of elderly patients with peptic ulcer,but the effect of pantoprazole on relieving symptoms is better than omeprazole.

Research progress of proton pump inhibitors on breast cancer / 实用肿瘤学杂志

In recent years,some studies have been shown that proton pump inhibitors(PPIs)not only play a role in digestive diseases,but it also has an important role in the treatment of breast cancer.PPIs,including omeprazole,pantoprazole,lansoprazole,esomeprazole,etc,improve the effect of breast cancer chemotherapy and induce breast cancer cell apoptosis by inhibiting intracellular proton excretion and increasing intracellular pH.This preview summarizes the study progress of PPIs in breast cancer and the potential application of PPIs in the treatment of breast cancer.

Determination of Pantoprazole Sodium Bioadhesive Tablets by HPLC / 中国药师

Objective:To establish a method to determine the contents of pantoprazole sodium bioadhesive tablets. Methods:An HPLC method was adopted. The determination was performed on a HYPERSIL ODS-2 (150 mm × 4. 6 mm, 5μm) column with mobile phase consisting of 0. 01 mol·L-1 dipotassium phosphate solution –methanol (60 ∶40) at the flow rate of 1. 0 ml·min-1 . The de-tection wavelength was set at 289 nm, the column temperature was maintained at 30 ℃ and the sample size was 20 μl. Results:The linear range of pantoprazole sodium was 1. 28-20. 60μg·ml-1,(r=0. 999 8) . The average recovery was 99. 52%(RSD=1. 43%, n=9). Conclusion:The method is simple, accurate and reliable, and can be used for determining the content of pantoprazole sodium bioadhesive tablets.

Determination of (S)-Pantoprazole Sodium in Dog Plasma by LC-MS/MS and Its Toxicokinetic Study / 中国药学杂志

OBJECTIVE: To establish an LC-MS/MS method to determine (S)-pantoprazole sodium in dog plasma and investigate its toxicokinetics. METHODS: After protein precipitation with acetonitrile, the analyte and internal standard were separated on CHIRALCEL OJ-RH column (4.6 mm ×150 mm, 5 μm) with acetonitrile-water (28∶72) as mobile phase eluted at a flow rate of 0.6 mL·min-1. Detection was carried out by electrospray positive ionization mass spectrometry in the multiple reaction monitoring (MRM) mode. The MRM transitions of m/z 384.0/199.8 and m/z 180.0/110.0 were used to quantify (S)-pantoprazole sodium and phenacetin, respectively. Beagle dogs were intravenously given (S)-pantoprazole sodium for 4 weeks at low, medium, and high dosages (10, 20, 40 mg·kg-1·d-1). RESULTS: The calibration curve was linear over the concentration range of 50-30 000 ng·mL-1. The RSDs were less than 15%, and the accuracy was in the range of 85%-115%. The AUC0-4 h and ρmax of (S)-pantoprazole sodium were proportional to the dosages. CONCLUSION: The established method can be applied to the determination of (S)-pantoprazole sodium in plasma of dogs and is suitable for the toxicokinetic study.

The efficacy and safety of Danhong injection combined with pantoprazole sodium on patients with acute exacerbation of respiratory failure / 中国生化药物杂志

Objective To investigate the clinical efficacy and safety of Danhong injection combined with pantoprazole sodium on patients with acute exacerbation of respiratory failure. Methods 104 patients with acute exacerbation of respiratory failure were treated in our hospital from January 2016 to January 2017. They were selected and equally divided into two groups with the method of random number table. The two groups were given the same basic treatment, and the control group was treated with pantoprazole sodium on this basis. The treatment group was treated with Danhong injection on the basis of the control group. The clinical efficacy and adverse reactions of two groups were recorded. Results After 15 days of the treatment, the total effective rate of the treatment group was 94.2%, which was significantly higher than that of the control group 71.2%(P<0.05). There was no significant difference in the incidence of adverse reactions between the control group and the treatment group. Conclusion Danhong injection combined with pantoprazole sodium is effective and safe in the treatment of acute exacerbations of respiratory failure, which is worthy of clinical practice and popularization.