Fármacos para o Controle da Acidez Gástrica e Protetores da Mucosa

Santos, Flávia Almeida, Rao, Vietla Satyanarayana

doi:10.5151/9788580391893-23

Fármacos para o Controle da Acidez Gástrica e Protetores da Mucosa

Santos, Flávia Almeida ; Rao, Vietla Satyanarayana

Resumo:

A secreção ácida gástrica pelas células parietais do estômago é um processo dinâmico regulado por vias neurais, hormonais e parácrinas, a nível central e periférico, assim como por estímulos mecânicos e químicos. Os principais estimulantes da produção ácida pelas células parietais são a histamina, a acetilcolina e a gastrina.

A secreção ácida estomacal facilita a digestão de proteínas, a absorção de ferro, cálcio e vitamina B12, e reduz o risco de infecções gastrintestinais (Helicobacter pylori, Vibrio cholera, Salmonella sp., dentre outros). Uma secreção ácida insuficiente pode resultar em má absorção e aumento na susceptibilidade a infecções gastrintestinais, enquanto excesso de secreção ácida pode causar desde a doença do refluxo gastroesofágico e úlcera péptica até danos mais severos à mucosa como podem ser vistos na síndrome de Zollinger–Ellison.

Download (PDF)

72 downloads

Sistema, digestório

DOI: 10.5151/9788580391893-23

Referências bibliográficas

AKIBA, Y.; KAUNITZ, J. D. Luminal chemosensing and upper gastrointestinal
mucosal defenses. The American Journal of Clinical Nutrition. 90(3):
826S-831S, 2009.
ANDERSSON, T. Pharmacokinetics, metabolism and interactions of acid pump
inhibitors. Focus on omeprazole, lansoprazole and pantoprazole. Clinical
Pharmacokinetics. 31(1): 9-28, 1996.
ARMSTRONG, J. A.; WEE, S. H.; GOODWIN, C. S.; WILSON, D. H. Response
of Campylobacter pyloridis to antibiotics, bismuth and an acid-reducing
agent in vitro-an ultrastructural study. Journal of Medical Microbiology.
24(4): 343-350, 1987.
ATKINSON, N. S.; REYNOLDS, D. J.; TRAVIS, S. P. Lemonade Legs: Why do
Some Patients Get Profound Hypomagnesaemia on Proton-Pump Inhibitors?.
Intestinal Research. 13(3): 227-232, 2015.
BARRETT, T. D.; LAGAUD, G.; WAGAMAN, P.; FREEDMAN, J. M.; YAN, W.;
ANDRIES, L.; RIZZOLIO, M. C.; MORTON, M. F.; SHANKLEY, N. P. The
cholecystokinin CCK2 receptor antagonist, JNJ-26070109, inhibits gastric
acid secretion and prevents omeprazole-induced acid rebound in the rat.
British Journal of Pharmacology. 166(5): 1684-1693, 2012.
CABOCLO, J. L.; CURY, FDE. A.; BORIN, A. A.; CABOCLO, L. O.; RIBEIRO,
M. F.; DE FREITAS, P. J.; ANDERSSON, S. Gastric secretion elicited by
conditioning in rats. Scandinavian Journal of Gastroenterology. 44(6): 672-
679, 2009.
CANDELLI, M.; CARLONI, E.; ARMUZZI, A.; CAMMAROTA, G.; OJETTI,
V.; PIGNATARO, G.; SANTOLIQUIDO, A.; POLA, R.; POLA, E.;
GASBARRINI, G.; GASBARRINI A. Role of sucralfate in gastrointestinal
diseases. Panminerva Medica. 42(1): 55-59, 2000.
CARDOSO, R. N.; BENJO, A. M.; DINICOLANTONIO, J. J.; GARCIA,
D. C.; MACEDO, F. Y.; EL-HAYEK, G.; NADKARNI, G. N.; GILI, S.;
IANNACCONE, M.; KONSTANTINIDIS, I.; REILLY, J. P. Incidence of
cardiovascular events and gastrointestinal bleeding in patients receiving
clopidogrel with and without proton pump inhibitors: an updated metaanalysis.
Open Heart. 2(1): e000248, 2015.
CENGIZ, N.; USLU, Y.; ·GÖK, F.; Anarat, A. Acute renal failure after overdose
of colloidal bismuth subcitrate. Pediatric Nephrology. 20(9): 1355-1358,
2005.
CHU, S.; SCHUBERT, M. L. Gastric secretion. Current Opinion in
Gastroenterology. 28(6): 587-593, 2012.
DEFONESKA A.; KAUNITZ, J.D. Gastroduodenal mucosal defense. Current
Opinion in Gastroenterology. 26(6): 604-610, 2010.
DELITALA, G.; DEVILLA, L.; PENDE, A.; CANESSA, A. Effects of the H2
receptor antagonist ranitidine on anterior pituitary hormone secretion in
man. European Journal of Clinical Pharmacology. 22(3): 207-211, 1982.
DREWELOW, B.; SCHAFFLER, K.; REITMEIR, P.; BETHKE, T. D. Effects of
multiple-dose esomeprazole and pantoprazole on diazepam pharmacokinetic
profi le and pharmacodynamic effects on cognitive and psychomotor function
in healthy volunteers. Arzneimittelforschung. 60(8): 483-491, 2010.
DUBB, J. W.; STOTE, R. M.; FAMILIAR, R. G.; LEE, K.; ALEXANDER, F.
Effect of cimetidine on renal function in normal man. Clinical Pharmacology
and Therapeutics. 24(1): 76-83, 1978.
EMERSON, C. R.; MARZELLA, N. Dexlansoprazole: A proton pump inhibitor
with a dual delayed-release system. Clinical Therapeutics. 32(9): 1578-1596,
2010.
EOM, C. S.; JEON, C. Y.; LIM, J. W.; CHO, E. G.; PARK, S. M.; LEE, K. S.
Use of acid-suppressive drugs and risk of pneumonia: a systematic review
and meta-analysis. Canadian Medical Association Journal. 183(3): 310-319,
2011.
ERICSSON, P.; HAKANSON, R.; REHFELD, J. F.; NORLÉN, P. Gastrin release:
antrum microdialysis reveals a complex neural control. Regulatory Peptides.
161(1-3): 22-32, 2010.
FELDMAN, M.; BURTON, M.E. Histamine2-receptor antagonists. Standart
therapy for acid-peptic diseases. 1. New England Journal of Medicine.
323(24): 1672-1680, 1990.
FORDTRAN, J. S.; MORAWSKI, S. G.; RICHARDSON, C. T. In vivo and in
vitro evaluation of liquid antacids. The New England Journal of Medicine.
288(18): 923-928, 1973.
FREEDBERG, D. E.; LEBWOHL, B.; ABRAMS, J. A. The impact of proton
pump inhibitors on the human gastrointestinal microbiome. Clinics in
Laboratory Medicine. 34(4): 771-785, 2014.
GALBRAITH, R. A.; MICHNOVICZ, J. J. The effects of cimetidine on the
oxidative metabolism of estradiol. New England Journal of Medicine. 321(5):
269-274, 1989.
GARCÍA RODRÍGUEZ, L. A.; JICK, H. Risk of gynaecomastia associated with
cimetidine, omeprazole, and other antiulcer drugs. British Medical Journal.
308(6927): 503-506, 1994.
GE, R.; SUN, H. Bioinorganic chemisry of bismuth and antimony: target sites of
metallodrugs. Accounts of Chemical Research. 40(4): 267-274, 2007.
GE, R.; SUN, X.; GU, Q.; WATT, R. M.; TANNER, J. A;WONG, B. C.,; XIA,
H. H.; HUANG, J. D.; HE, Q. Y.; SUN, H. A proteomic approach for the
identifi cation of bismuth-binding proteins in Helicobacter pylori. Journal of
Biological Inorganic Chemistry. 12(6): 831-842, 2007.
GE, R.; CHEN, Z.; ZHOU, Q. The actions of bismuth in the treatment of
Helicobacter pylori infections: an update. Metallomics. 4(3): 239-243, 2012.
GOODWIN, C. S.; ARMSTRONG, J. A.; COOPER, M. Colloidal bismuth
subcitrate inhibits the adherence of H. Pylori to epithelial cells. Italian
Journal of Gastroenterology. 23(Suppl. 2): 40, 1991.
JAIN, R. N.; SAMUELSON, L. C. Differentiation of the gastric mucosa. II. Role
of gastrin in gastric epithelial cell proliferation and maturation. American
Journal of Hhysiology, Gastrointestinal and Liver Physiology. 291(5): G762-
765, 2006.
JENSEN, R. T.; COLLEN, M. J.; PANDOL, S. J.; ALLENDE, H. D.; RAUFMAN,
J. P.; BISSONNETTE, B. M.; DUNCAN, W. C.; DURGIN, P. L.; GILLIN,
J. C.; GARDNER, J. D. Cimetidine-induced impotence and breast changes
in patients with gastric hypersecretory states. New England Journal of
Medicine. 308(15): 883-887, 1983.
KEOGAN, D. M.; GRIFFITH, D. M. Current and potential applications of
bismuth-based drugs. Molecules. 19(9): 15258-15297, 2014.
KLOTZ, U. Pharmacokinetic considerations in the eradication of Helicobacter
pylori. Clinical Pharmacokinetics. 38(3): 243-270, 2000.
KNIGGE, U.; DEJGAARD, A.; WOLLESEN, F.; INGERSLEV, O.; BENNETT, P.;
CHRISTIANSEN, P. M. The acute and long term effect of the H2-receptor
antagonists cimetidine and ranitidine on the pituitary-gonodal axis in
men. Clinical Endocrinology (Oxford). 18(3): 307-313, 1983.
KONTUREK, S. J.; RADECKI, T.; PIASTUCKI, I.; DROZDOWICZ, D.
Advances in the understanding of the mechanism of cytoprotective action
by colloidal bismuth subcitrate. Scandinavian Journal of Gastroenterology.
122(Supplement): 6-10, 1986.
KULAKSIZ, H.; ARNOLD, R.; GOKE, B.; MARONDE, E.; MEYER, M.;
FAHRENHOLZ, F.; FORSSMANN, W. G.; EISSELE, R. Expression and cellspecifi
c localization of the cholecystokinin B/gastrin receptor in the human
stomach. Cell and Tissue Research. 299(2): 289-298, 2000.
KWOK, C. S.; ARTHUR, A. K.; ANIBUEZE, C. I.; SINGH, S.; CAVALLAZZI, R.;
LOKE, Y. K. Risk of Clostridium diffi cile infection with acid suppressing drugs
and antibiotics: meta analysis. The American Journal of Gastroenterology. 107(7): 1011-1019, 2012.
KSIADZYNA, D.; SZELAG, A.; PARADOWSKI, L. Overuse of proton pump
inhibitors. Polskie Archiwum Medycyny Wewnętrznej. 125(4): 289-298,
2015.
LAMBERT, J. R.; MIDOLO, P. The actions of bismuth in the treatment of
Helicobacter pylori infection. Alimentary Pharmacology and Therapeutics.
11(Suppl 1): 27-33, 1997.
LEE, S. P. A potential mechanism of action of colloidal bismuth subcitrate: diffusion
barrier to hydrochloric acid. Scandinavian Journal of Gastroenterology.
80(Suppl): 17–21, 1982.
LEE, S.P. The mode of action of colloidal bismuth subcitrate. Scandinavian journal
of gastroenterology. 185: 1-6, 1991.
LEROTIĆ, I.; BARŠIĆ, N.; STOJSAVLJEVIĆ, S.; DUVNJAK, M. Acid inhibition
and the acid rebound effect. Digestive Diseases. 29(5): 482-486, 2011.
LI X. Q.; ANDERSSON, T. B.; AHLSTRÖM, M.; WEIDOLF, L. Comparison
of inhibitory effects of the proton pump-inhibiting drugs omeprazole,
esomeprazole, lansoprazole, pantoprazole, and rabeprazole on human
cytochrome P450 activities. Drug Metabolism and Disposition. 32(8): 821-
827, 2004.
LUNDELL, L.; VIETH, M.; GIBSON, F.; NAGY, P.; KAHRILAS, P. J.
Systematic review: the effects of long-term proton pump inhibitor use on
serum gastrin levels and gastric histology. Alimentary Pharmacology and
Therapeutics. 42(6): 649-663, 2015.
MASCLEE, G. M.; COLOMA, P. M.; KUIPERS, E. J. STURKENBOOM, M. C.
Increased risk of microscopic colitis with use of proton pump inhibitors and
non-steroidal anti-inflammatory drugs. The American Journal of
Gastroenterology. 110(5): 749-759, 2015.
MATON, P. N.; BURTON, M. E. Antiacids revised: A review of their clinical
pharmacology and recommended therapeutic use. Drugs. 57(6): 855-870,
1999.
McCARTHY, D. M. Sucralfate. The New England Journal of Medicine. 325(14):
1017-1025, 1991.
MEHTA, A.; MEHTA, D.; LOGANATHAN, J.; PALADUGU, N.; BHALODKAR,
N.C. Clopidogrel with proton pump inhibitors: safe or not? Clinical
Cardiology. 34(9): 528-531, 2011.
NAGASHIMA, R.; YOSHIDA, N. Sucralfate, a basic aluminum salt of sucrose
sulfate. I. Behaviors in gastroduodenal pH. Arzneimittelforschung. 29(11):
1668-1676, 1979.
NELIS, G. F.; VAN DE MEENE, J. G. Comparative effect of cimetidine and
ranitidine on prolactin secretion. Postgraduate Medical Journal. 56(657):
478-480, 1980.
NELIS, G. F.; VAN DE MEENE, J. G. The effect of oral cimetidine on the basal
and stimulated values of prolactina, thyroid stimulating hormone, follicle
stimulating hormone and luteinizing hormone. Postgraduate Medical
Journal. 56(651): 26-29, 1980.
PEDEN, N. R.; BOYD, E. J.; BROWNING, M. C.; SAUNDERS, J. H.; WORMSLEY,
K. G. Effects of two histamine H2-receptor blocking drugs on basal levels
of gonadotrophins, prolactin, testosterone ando estradiol-17 beta during
treatment of duodenal ulcer in male patients. Acta Endocrinologica (Copenh).
96(4): 564-568, 1981.
PEDEN, N. R.; WORMSLEY, K. G. Effect of cimetidine on gonadal function in
man. British Journal of Clinical Pharmacology. 14(4): 565, 1982.
PETERSON, W. L.; CIOCIOLA, A. A.; SYKES, D. L.; MCSORLEY, D. J.; WEBB,
D. D. Ranitidine bismuth citrate plus clarithromycin is effective for healing
duodenal ulcers, eradicating H. pylori and reducing ulcer recurrence. RBC
H. pylori Study Group. Alimentary Pharmacology and Therapeutics. 10(3):
251-261, 1996.
PIPKIN, G. A.; MILLS, J. G.; KLER, L.; DIXON, J. S.; WOOD, J. R. The safety of
ranitidine bismuth citrate in controlled clinical studies. Pharmacoepidemiology
and Drug Safety. 5(6): 399-407, 1996.
SCHENTAG, J. J.; CERRA, F. B.; CALLERI, G.; DEGLOPPER, E.; ROSE, J. Q.;
BERNHARD, H. Pharmacokinetic and clinical studies in patients with
cimetidine-associated mental confusion. Lancet. 1(8109): 177-181, 1979.
SCHMITZ, F.; GOKE, M. N.; OTTE, J. M.; SCHRADER, H.; REIMANN, B.;
KRUSE, M. L.; SIEGEL, E. G.; PETERS, J.; HERZIG, K. H., FOLSCH, U. R.;
SCHMIDT, W. E. Cellular expression of CCK-A and CCK-B/gastrin receptors
in human gastric mucosa. Regulatory Peptides. 102(2-3): 101-110, 2001.
SCHUBERT M. L.; PEURA, D. A. Control of gastric acid secretion in health and
disease. Gastroenterology. 134(7): 1842-1860, 2008.
SCHUBERT, M.L. Gastric secretion. Current Opinion in Gastroenterology. 26(6):
598-603, 2010.
SHEEN, E.; TRIADAFILOPOULOS, G. Adverse effects of long-term proton pump
inhibitor therapy. Digestive Diseases and Sciences. 56(4): 931-950, 2011.
SHI, S.; KLOTZ U. Proton pump inhibitors: an uptade of their clinical use and
pharmacokinetics. European Journal of Clinical Pharmacology. 64(10): 935-
951, 2008.
SHIN, J. M.; KIM, N. Pharmacokinetics and pharmacodynamics of the proton
pump inhibitors. Journal of Neurogastroenterology and Motility. 19(1): 25-
35, 2013.
SHIN, J. M., SACHA, G. Pharmacology of proton pump inhibitors. Current
Gastroenterology Reports. 10(6): 528-534, 2008.
SHIN, J. M.; MUNSON, K.; VAGIN, O.; SACHS, G. The gastric HK-ATPase:
structure, function, and inhibition. Pfl ügers Archiv. 457(3): 609-622, 2009.
SLOMIANY, B. L.; KASINATHAN, C.; SLOMIANY, A. Lipolytic activity
of Campylobacter pylori: effect of colloidal bismuth subcitrate (De-
Nol). American Journal of Gastroenterology. 84(10): 1273-1277, 1989.
SOLL, A. H.; WOLLIN, A. Histamine and cyclic AMP in isolated canine parietal
cells. American Journal of Physiology. 237(5): E444-450, 1979.
SOMOGYI, A.; GUGLER, R. Clinical pharmacokinetics of cimetidine. Clinical
Pharmacokinetics. 8(6): 463-495, 1983.
SOX, T. E.; OLSON, C. A. Binding and killing of bacteria by bismuth subsalicylate.
Antimicrobial Agents and Chemotherapy. 33(12), 1989.
STABLES, R.; CAMPBELL, C. J.; CLAYTON, N. M.; CLITHEROW, J. W.;
GRINHAM, C. J.; MCCOLM, A. A.; MCLAREN, A.; TREVETHICK, M. A.
Gastric anti-secretory, mucosal protective, anti-pepsin and anti-Helicobacter
properties of ranitidine bismuth citrate. Alimentary Pharmacology and
Therapeutics. 7(3): 237-246, 1993.
STEDMAN, C. A. M.; BARCLAY, M. L. Review article: comparison of
the pharmacokinetics, acid suppression and effi cacy of proton pump
inhibitors. Alimentary Pharmacology and Therapeutics. 14(8): 963-978,
2000.
SZABO, S. Gastric cytoprotection is still relevant. Journal of Gastroenterology
and Hepatology. 29(Suppl. 4): 124-132, 2014.
TANAKA, S.; GUTH, P. H.; PAULSEN, G.; KAUNITZ, J. D. Gastroprotective
effect of ranitidine bismuth citrate is associated with increased mucus
bismuth concentration in rats. Gut. 39(2): 164-171, 1996.
TAKEUCHI, K.; KOYAMA, M.; HAYASHI, S.; AIHARA, E. Prostagladin
EP receptor subtypes involved in regulating HCO(3)(-) secretion from
gastroduodenal mucosa. Current Pharmaceutical Design. 16(10): 1241-
1251, 2010.
TARI, A.; KAMIYASU, T.; YONEI, Y.; HAMADA, M.; SUMII, M.; SUMII, K.;
KAJIYAMA, G.; DIMALINE, R. Role of gastrin/CCK-B receptor in the
regulation of gastric acid secretion in rat. Digestive Diseases and Sciences.
42(9): 1901-1907, 1997.
TOMMERAS, K.; HAMMER, P.; SUNDLER, F.; BORCH, K.; MARDH, S.;
CABERO, J. L. Immunolocalization of cholecystokinin-2 receptors in rat
gastric mucosa. Scandinavian Journal of Gastroenterology. 37(9): 1017-
1024, 2002.
VAKILY, M.; ZHANG, W.; WU, J.; ATKINSON, S. N.; MULFORD, D.
Pharmacokinetics and pharmacodynamics of a known active PPI with a novel
dual delayed release techonology, dexlansoprazole MR: a combined analysis
of randomized clinical trials. Current Medical Research and Opinion. 25(3):
627-638, 2009.
VUYYURU, L.; SCHUBERT, M. L.; HARRINGTON, L.; ARIMURA, A.;
MAKHLOUF, G. M. Dual inhibitory pathways link antral somatostatin
and histamine secretion in human, dog, and rat stomach. Gastroenterology.
109(5): 1566-1574, 1995.
VUYYURU, L., HARRINGTON, L.; ARIMURA, A.; SCHUBERT, M. L.
Reciprocal inhibitory paracrine pathways link histamine and somatostatin
secretion in the fundus of the stomach. American Journal of Physiology.
273(1): G106-111, 1997.
YU, E. W.; BAUER, S. R.; BAIN, P. A.; BAUER, D. C. Proton pump inhibitors and
risk of fractures: a meta-analysis of 11 international studies. The American
Journal of Medicine. 124(6): 519-526, 2011.
WEDEMEYER, R. S.; BLUME, H. Pharmacokinetic drug interaction profi les of
proton pump inhibitors: an uptade. Drug Safety. 37(4): 201-211, 2014.

Como citar:

SANTOS, Flávia Almeida; RAO, Vietla Satyanarayana; "Fármacos para o Controle da Acidez Gástrica e Protetores da Mucosa", p. 645-670. Sistema digestório: integração básico-clínica. São Paulo: Blucher, 2016.
ISBN: 9788580391893, DOI 10.5151/9788580391893-23