| 特集名 | PPIの長期投与 | |
|---|---|---|
| 題名 | 長期投与における市販PPI3種の差異 | |
| 発刊年月 | 2002年 02月 | |
| 著者 | 島谷 智彦 | 広島大学医学部附属病院総合診療部 |
| 著者 | 井上 正規 | 広島大学医学部保健学科地域・老人看護学 |
| 【 要旨 】 | わが国で発売中の3種のプロトンポンプ阻害剤(PPI)の長期投与における差異について検討した． 胃酸分泌抑制作用や，逆流性食道炎の維持療法における長期投与の成績などには，明らかな差は見出せない． PPIの代謝に関連するcytochrome P450(CYP)2C19の活性には個人差があり，omeprazoleとlansoprazoleにおいて胃酸分泌抑制作用に有意差を生じ，また薬物間相互作用の原因となる．さらにomeprazoleとlansoprazoleはCYP1A1とCYP1A2を誘導し，相互作用の原因となる．なお，rabeprazoleは非酵素的にも代謝されるため，相互作用は3種のうちでもっとも少ない． |
|
| Theme | PPI Therapy | |
|---|---|---|
| Title | Evaluation of Three Proton Pump Inhibitors in Long-Term Treatment of Acid-Related Disease | |
| Author | Tomohiko Shimatani | Department of General Medicine, Hiroshima University Hospital |
| Author | Masaki Inoue | Department of Community and Geriatric Nursing, Institute of Health Sciences, Hiroshima University School of Medicine |
| [ Summary ] | Proton pump inhibitors (PPIs) have influenced the management of acid-related diseases over the last 10 years. In Japan, three PPIs are now available; omeprazole, lansoprazole and rabeprazole. Acid suppression studies comparing these agents suggest equivalent potency. Most studies have not shown significant differences, when used in standard doses for maintenance therapy of reflux esophagitis. All PPIs may interact with other medications by increasing gastric pH, thereby changing drug absorption. They are metabolized by cytochrome P450(CYP) 2C19 and 3A4. Minor mutations in CYP2C19 affect its activity in the liver, and, in turn, the metabolic and pharmacokinetic profiles of them. Omeprazole may inhibit CYP2C19, and omeprazole and lansoprazole may induce CYP1A1 and 1A2, resulting in some drug-drug interactions. Rabeprazole has been shown to be the least affected by the CYP2C19-related polymorphism. |
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