AGENTS AFFECTING GASTROINTESTINAL FUNCTION
Keywords:
Pharmacology, gastrointestinal tract, proton pump inhibitors, H2-receptor antagonists, gastric acid secretionAbstract
Acid-related gastrointestinal disorders, including peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD), represent a significant clinical burden worldwide. This study evaluates the comparative pharmacological efficacy, onset of action, and safety profiles of proton pump inhibitors (omeprazole) versus H2-receptor antagonists (famotidine) in regulating gastric acid secretion. A systematic review and comparative observational analysis were conducted on clinical cohorts receiving standard therapeutic regimens over an 8-week period. Results demonstrated that omeprazole achieved superior 24-hour intragastric pH control (\(pH > 4.0\) for \(16.4 \pm 2.1\) hours) and higher mucosal healing rates (91.2%) compared to famotidine (74.5%, \(p < 0.01\)). However, famotidine exhibited a faster initial onset of symptom relief within the first 60 minutes. Both drug classes were well-tolerated, with mild headache and gastrointestinal discomfort being the most common adverse events. In conclusion, while proton pump inhibitors remain the gold standard for sustained acid suppression and mucosal healing, H2-receptor antagonists offer valuable rapid-onset relief for episodic symptoms.
References
1.Bell, N. J., Burget, D., Howden, C. W., Wilkinson, J., & Hunt, R. H. (1992). Appropriate acid suppression for the management of gastro-oesophageal reflux disease. Digestion, 51(Suppl. 1), 59–67. doi.org
2.Brunton, L. L., & Knollmann, B. C. (Eds.). (2023). Goodman & Gilman's: The Pharmacological Basis of Therapeutics (14th ed.). McGraw-Hill Education.
3.Freedberg, D. E., Kim, L. S., & Yang, Y. X. (2017). The risks and benefits of long-term use of proton pump inhibitors: Expert review and best practice advice from the American Gastroenterological Association. Gastroenterology, 152(4), 706–715. doi.org
4.Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2022). ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. The American Journal of Gastroenterology, 117(1), 27–56. doi.org
5.Katzung, B. G., & Vanderah, T. W. (2024). Basic & Clinical Pharmacology (16th ed.). McGraw-Hill Education.
6.Lanas, A., & Chan, F. K. L. (2017). Peptic ulcer disease. The Lancet, 390(10094), 613–624. doi.org
7.McRorie, J. W., Kirby, J. A., & Miner, P. B. (2014). Histamine2-receptor antagonists: Rapid development of tachyphylaxis with repeat dosing. World Journal of Gastrointestinal Pharmacology and Therapeutics, 5(2), 57–62. doi.org
8.Scarpignato, C., Gatta, L., Zullo, A., & Blandizzi, C. (2016). Effective and safe proton pump inhibitor therapy in acid-related diseases – A position paper addressing benefits and potential harms of acid suppression. BMC Medicine, 14(1), 179. doi.org
9.Shin, J. M., & Sachs, G. (2008). Pharmacology of proton pump inhibitors. Current Gastroenterology Reports, 10(6), 528–534. doi.org
10.Strand, D. S., Kim, D., & Peura, D. A. (2017). 25 years of proton pump inhibitors: A comprehensive review. Gut and Liver, 11(1), 27–37. doi.org
11.Wallace, J. L., & Sharkey, K. A. (2018). Pharmacotherapy of gastric acidity, peptic ulcers, and gastroesophageal reflux disease. In Goodman & Gilman's: The Pharmacological Basis of Therapeutics (13th ed., pp. 909–922). McGraw-Hill Education.
12.World Health Organization. (2023). WHO Model List of Essential Medicines – 23rd List, 2023. World Health Organization.
