The selection of a medicine for heartburn occurs on the basis of the diagnosis that led to the occurrence of this symptom.. Heartburn is based on the return of acidic gastric contents into the esophagus (gastroesophageal reflux) and, as a result, irritation and burning of the mucous membrane. There are quite a few reasons for this phenomenon (malnutrition, stress, overweight), but in the first place are acute or chronic diseases of the stomach (gastroesophageal reflux disease, or GERD, peptic ulcer, gastritis). Prevalence is ubiquitous. No gender correlation. There is no dependence on age either, according to the Internet edition for girls and women from 14 to 35 years old Pannochka. net Any medicine for heartburn should be prescribed by a doctorClassification of drugsThe classification of drugs for heartburn can be represented as follows:.

Means that suppress the secretion of hydrochloric acid: proton pump blockers; H2-prescription antagonists, M-anticholinergics.

Antibacterial agents for the destruction of Helicobacter pylori - are included in the treatment regimen for certain diseases accompanied by heartburn, but are prescribed only after histological and cytological confirmation of the diagnosis.

Antacids.

Gastrocytoprotectors.

The last two groups are used as symptomatic therapy..

Proton pump blockers The most effective group of drugs for heartburn - suppresses the production of hydrochloric acid. After taking them, the acidity of the gastric juice is significantly reduced, and the discomfort from the esophagus disappears..

The mechanism of action is the irreversible blockade of the proton pump (enzyme H + / K + -ATP-ase) of the parietal cells of the stomach. Chemically, they are weak bases.. Once in the stomach, they are localized in the area of \u200b\u200bthe tubules of the parietal cells, which are responsible for the synthesis of hydrochloric acid.. There they irreversibly bind to some of the receptors on the cell surface.. After the first application, no more than 60% of the cells are suppressed, so it is necessary to take drugs for a long time.

On the market, the main prototype of this group is Omeprazole.. The remaining funds are represented by its analogues, which differ in price, speed and drug interactions..

List of drugs:.

A drug.

Description.

Omeprazole.

Exists in the form of inexpensive domestic pills for heartburn, also available in pharmacies in the form of imported drugs (Omez). Price difference. It is usually produced in the form of capsules.. Bioavailability no more than 60% (weak effect after the first dose). Prolonged absorption - 1-2 hours. It is permissible to use together with antacids, partly has an antacid effect itself. Drink one capsule once a day (you can use it according to other schemes, which will depend on the underlying disease). Acceptable during pregnancy and lactation.

Esomeprazole.

The main difference is in high bioavailability (up to 80%), that is, it has a pronounced effect from the first application.. It is excreted through the liver, so the dose is selected taking into account concomitant diseases..

Pantoprazole.

A distinctive feature of the drug is the absence of drug interactions (does not cause cross-reactions with other drugs). Bioavailability about 78%. There are release forms for intravenous use. Rapid elimination from the body (less than 4 hours).

Omez is an imported drug from the group of proton pump blockers. Side effects for all drugs in this group:.

from the gastrointestinal tract (often) - constipation / diarrhea, pain, nausea, flatulence;

from the nervous system (often) - headache, insomnia;

on the part of the liver and biliary system - a laboratory increase in liver enzymes;

from other organs and systems - there are side effects, but the frequency of their occurrence is minimal (1-2%).

H2 receptor antagonistsHistamine receptor blockers (H2 receptors) are localized in the postsynaptic membrane (control of the parietal cells of the stomach).

Sample drugs: Cimetidine, Ranitidine, Famotidine and Nizatidine. Currently inferior to proton pump blockers. Used in clinical practice less frequently than drugs of other groups.

Admission effects:.

strengthening of the contractile function of the stomach (acceleration of emptying);

suppression of the secretion of hydrochloric acid by inhibiting the work of parietal cells.

Feature in low toxicity (less than 1% of the population is subject to adverse reactions).

Topical drugs:.

A drug.

Description.

Nizatidine.

Has maximum bioavailability (90%). The maximum concentration in the blood after 1-2 hours. Excreted by the kidneys unchanged. Contraindicated in children under 12 years of age, pregnant and lactating.

Ranitidine.

Has an average bioavailability (45-50%). Duration of action up to 12 hours. Excreted by the kidneys (caution when prescribing to persons with renal insufficiency). Available in the form of tablets. Contraindicated in children under 12 years of age, pregnant and lactating.

Ranitidine is a drug of the H2 receptor antagonist group. Side effects are the same for all drugs in this group:.

diarrhea/constipation;

drowsiness and headache;

skin rash;

joint pain.

M-anticholinergics Muscarinic receptors (M-cholinergic receptors) are receptors that are activated by muscarine. In this case, we are talking about blocking nerve impulses through receptors further along the nervous system..

Location of receptors:.

CNS;

endings of postganglionic parasympathetic nerve fibers;

endings of postganglionic sympathetic nerve fibers.

According to localization, they are divided into:.

presynaptic;

postsynaptic (M1, M2, M3).

M-anticholinergics are represented by tertiary and quaternary amines (the latter do not affect the central nervous system). Effects of blocking nerve impulses through muscarinic receptors (explains the use of these drugs for heartburn and other diseases of the stomach and esophagus):.

decreased secretion of all endocrine glands (including the production of hydrochloric acid and gastric enzymes);

reduces motor activity of the gastrointestinal tract and promotes relaxation of intestinal smooth muscles.

There are other effects, but they are not related to heartburn..

Used for peptic ulcer to relieve pain and reduce the secretion of hydrochloric acid.

They are used relatively less frequently than drugs of other groups..

Gastrocepin is a drug of the M-anticholinergic group The most relevant drug in this group is Gastrocepin (pirenzepine). It does not penetrate the central nervous system (there are no adverse reactions such as psychosis and hallucinations). Available in different forms (tablets, intramuscular and intravenous injections). It has a small list of side effects (dry mouth, diarrhea, accommodation), but also low efficiency.

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