de Prados Carlos Martín de Argila
Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España.
Gastroenterol Hepatol. 2010 May;33 Suppl 1:5-10. doi: 10.1016/S0210-5705(10)70002-9.
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.
质子泵抑制剂（PPI）是控制胃酸分泌最有效且效力最强的药物，也是全球处方量最大的药物类别之一。PPI的安全性和有效性已在临床实践中得到证实，目前这些药物是消化性溃疡疾病、幽门螺杆菌感染、胃食管反流病、非甾体抗炎药所致胃病及功能性消化不良的首选治疗药物。然而，尽管目前的PPI具有出色的药理学特性，但在某些疾病中其起效速度可能不够快，并非总能实现24小时胃酸抑制，并且——取决于PPI的不同分子——胃抗分泌效果存在个体差异，这取决于CYP2C19的基因多态性，可能会影响不同PPI的个体代谢。新一代的这类药物可能会消除这些不足。
