proton pump inhibitor mechanism of action pdf generator

Its efficiency is similar to ticlopidine but it is tolerated better (2 and 4). CPDG is a second generation thienopyridine prodrug. It is usually prescribed together with a proton pump inhibitor which reduces the risk of gastrointestinal bleeding (GIB) (3). Clopidogrel (CPDG) has been approved as a first line treatment for reducing major cardiovascular events such as death from cardiovascular origin, stent thrombosis, acute coronary syndrome, and recurrent revascularization (2). The proton pump inhibitors (PPIs) are one of the most commonly prescribed medications in the world, with more than 12.4 million prescriptions in 2004 in Canada (1). Proton pump inhibitors, clopidogrel, P450, thrombosis If a PPI is to be used on patients who take clopidogrel, the use of Pantoprazole or Esomeprazole is recommended because they exert minimal inhibition on CYP2C19. Nevertheless, evidence is contradictory, and until now no clinical trials have been performed to clear up doubts. The competitive inhibition that these generate on the hepatic enzymatic system probably activates clopidogrel, thus causing a decrease in its effectiveness as an antithrombotic. Recently the interaction between proton pump inhibitors and clopidogrel has been widely brought to attention. It is a pro-drug that must be converted at hepatic level into its active form by the CYP2C19 isoenzyme. (2) Associate Profesor of Medicine, Gastroenterology Unit, Universidad Nacional de ColombiaĬlopidogrel, a thienopyridine, is an antiplatelet drug which currently represents the cornerstone for the treatment of acute coronary events.

(1) Internal Medicine Resident, Universidad Nacional de Colombia Ingrid Martínez MD (1), Vivian Coy MD (1), William Otero MD (2)

Proton pump inhibitors and clopidogrel: Evidence of a Pharmacological interaction of great clinical impact

Proton pump inhibitor mechanism of action pdf generator