Mark Currivan - The Drug Recognition Guide

Bisacodyl

Co‐danthramer

Co‐danthrusate

Docusate sodium

Ispaghula husk

Lactulose

Prucalopride

Senna

Sodium picosulfate

Sterculia

Do not confuse dantron(a component of both co‐danthramerand co‐danthrusate) with the antiemetic ondansetron(see Chapter 7). Similarly, do not mistake the laxative prucalopridefor a benzamide class antipsychotic (i.e., amisulpride, see Chapter 5).

The parietal cells in the stomach release a stream of enzymes known as the hydrogen–potassium adenosine triphosphatase enzyme system (commonly called ‘the proton pump’). This is the final (and crucial) step in the process of gastric acid secretion. Proton pump inhibitors (PPIs), as their name indicates, are drugs that inhibit the proton pump, thereby reducing gastric acid secretion. PPIs are effective in treating dyspepsia, oesophageal reflux, in preventing or treating peptic ulcers and in helping eradicate Helicobacter pylori (Strand et al., 2017). First introduced in the late 1980s, PPIs are now among the most commonly prescribed drugs in the world (Savarino et al., 2017). PPI names end in ‘‐ prazole’.

Esomeprazole

Lansoprazole

Omeprazole

Pantoprazole

Rabeprazole

Note an exception: a drug ending in ‘‐ prazole’ that is not a proton pump inhibitor: aripiprazole(an atypical antipsychotic drug: see Chapter 5).

Do not mistake PPIs ending in ‘‐ prazole’ for antibiotics ending in ‘‐ nidazole’ (i.e., metronidazole) or ‘‐ oxazole’ (i.e., co‐trimoxazole) (see Chapter 9); or antifungals ending in ‘‐ conazole’ (i.e., fluconazole: Chapter 9) or hormone antagonists ending in ‘‐ rozole’ (i.e., letrozole: Chapter 10) [chemically, all of the above are azole derivatives, hence their ‘‐ zole’ suffix].

1 Ford, A.C., Talley, N.J., Spiegel, B.M. et al. (2008). Effect of fibre, antispasmodics and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta‐analysis. British Medical Journal, 337, a2313.

2 Keshav, S. and Bailey, A. (2013). The gastrointestinal system at a glance. 2nd ed. Chichester: Wiley Blackwell.

3 Puttmann, M. and Roett, M.A. (2011). H2 blockers are as effective as PPIs for long‐term relief of non‐ulcer dyspepsia. Evidence‐Based Practice, 14 (2), 14.

4 Ruepert, L., Quartero, A.O., de Wit, N.J. et al. (2011). Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database of Systematic Reviews [online]. Available from: doi: 10.1002/14651858.CD003460.pub3.

5 Savarino, V., Dulbecco, P., de Bortoli, N. et al. (2017). Appropriate use of proton pump inhibitors (PPIs): need for a reappraisal. European Journal of Internal Medicine, 37, 19–24 [online]. Available from: doi: 10.1016/j.ejim.2016.10.007.

6 Strand, D.S., Kim, D. and Peura, D.A. (2017). 25 years of proton pump inhibitors: a comprehensive review. Gut and Liver, 11 (1), 27–37 [online]. Available from: doi: 10.5009/gnl.15502.

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