| Title |
Proton Pump Inhibitors in Pediatrics
|
|---|---|
| Published in |
Pediatric Drugs, March 2013
|
| DOI | 10.1007/s40272-013-0012-x |
| Pubmed ID | |
| Authors |
Robert M. Ward, Gregory L. Kearns |
| Abstract |
Proton pump inhibitors (PPIs) have become some of the most frequently prescribed medications for treatment of adults and children. Their effectiveness for treatment of peptic conditions in the pediatric population, including gastric ulcers, gastroesophageal reflux disease (GERD), and Helicobacter pylori infections has been established for children older than 1 year. Studies of the preverbal population of neonates and infants have identified doses that inhibit acid production, but the effectiveness of PPIs in the treatment of GERD has not been established except for the recent approval of esomeprazole treatment of erosive esophagitis in infants. Reasons that have been proposed for this are complex, ranging from GERD not occurring in this population to a lack of histologic identification of esophagitis related to GERD to questions about the validity of symptom scoring systems to identify esophagitis when it occurs in infants. The effectiveness of PPIs relates to their structures, which must undergo acidic activation within the parietal cell to allow the PPI to be ionized and form covalent disulfide bonds with cysteines of the H(+)-K(+)-adenosine triphosphatase (H(+)-K(+)-ATPase). Once the PPI binds to the proton pump, the pump is inactivated. Some PPIs, such as omeprazole and rabeprazole bind to cysteines that are exposed, and their binding can be reversed. After irreversible chemical inhibition of the proton pump, such as occurs with pantoprazole, the recovery of the protein of the pump has a half-life of around 50 h. Cytochrome P450 (CYP) 2C19 and to a lesser degree CYP3A4 clear the PPIs metabolically. These enzymes are immature at birth and reach adult levels of activity by 5-6 months after birth. This parallels studies of the maturation of CYP2C19 to adult levels by roughly the same age after birth. Specific single nucleotide polymorphisms of CYP2C19 reduce clearance proportionally and increase exposure and prolong proton pump inhibition. Prolonged treatment of pediatric patients with PPIs has not caused cancer or significant abnormalities. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 222 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | <1% |
| India | 1 | <1% |
| Unknown | 219 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 37 | 17% |
| Student > Master | 34 | 15% |
| Researcher | 21 | 9% |
| Other | 19 | 9% |
| Student > Postgraduate | 16 | 7% |
| Other | 38 | 17% |
| Unknown | 57 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 74 | 33% |
| Pharmacology, Toxicology and Pharmaceutical Science | 33 | 15% |
| Nursing and Health Professions | 11 | 5% |
| Agricultural and Biological Sciences | 11 | 5% |
| Chemistry | 7 | 3% |
| Other | 15 | 7% |
| Unknown | 71 | 32% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 February 2016.
All research outputs
#14,004,469
of 23,232,430 outputs
Outputs from Pediatric Drugs
#366
of 560 outputs
Outputs of similar age
#109,811
of 198,627 outputs
Outputs of similar age from Pediatric Drugs
#11
of 14 outputs
Altmetric has tracked 23,232,430 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 560 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.6. This one is in the 34th percentile – i.e., 34% of its peers scored the same or lower than it.
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