Información del artículo
Resumen
Los inhibidores de la bomba de protones (IBP) son los fármacos más potentes y eficaces para el control de la secreción ácida gástrica y constituyen uno de los grupos farmacológicos más prescritos en todo el mundo. Estos fármacos han demostrado su eficacia y alta seguridad en la práctica clínica, y en la actualidad son el tratamiento de elección en la enfermedad ulcerosa péptica y la infección por Helicobacter pylori, la enfermedad por reflujo gastroesofágico, la gastropatía por antiinflamatorios no esteroideos y la dispepsia funcional. Sin embargo, a pesar del excelente perfil farmacológico de los IBP actuales, su rapidez de acción puede ser insuficiente en algunas enfermedades, no logran cubrir las 24 h del día de inhibición ácida y, de modo diferente según las distintas moléculas de IBP, presentan una variabilidad interindividual de eficacia antisecretora gástrica en función del polimorfismo genético de metabolización de la isoenzima CYP2C19 del CYP450. Es probable que nuevas generaciones de estos fármacos subsanen estas deficiencias.
Palabras clave:
Inhibidor bomba de protones
Úlcera
Enfermedad por reflujo gastroesofágico
Antiinflamatorios no esteroideos
Dispepsia
Helicobacter pylori
Abstract
Proton pump inhibitors (PPI) are the most potent and effective drugs for the control of gastric acid secretion and constitute one of the most widely prescribed pharmacological groups worldwide. The safety and efficacy of PPI have been demonstrated in clinical practice and these drugs are currently the treatment of choice in peptic ulcer diseases, Helicobacter pylori infection, gastroesophageal reflux disease, nonsteroidal antiinflammatory drug gastropathy and functional dyspepsia. However, despite the excellent pharmacological profile of current PPI, their rapidity of action may be insufficient in some diseases, 24-hour acid inhibition is not always achieved and - to a greater or lesser extent depending on the distinct molecules of the PPI - there is interindividual variability in gastric antisecretory efficacy, depending on genetic polymorphism of CYP2C19, which could affect individual metabolism of the distinct PPI. New generations of these drugs will probably eliminate these deficiencies.
Keywords:
Proton pump inhibitors
PPI
ulcer
gastroesophageal reflux disease
nonsteroidal antiinflammatory drug
dyspepsia
Helicobacter pylori
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