[india-drug] Re: Omeprazole (6)

["Pranav Gupta" <pranavgupta@hotmail.com>]

Omeprazole (6)
******** 

Hello Dr. Khan (Now...that is not 'sir'),

Thank u for replying.

First, there are situations where a combination of PPI and antacids do tend 
to occur (a patient on PPI feels discomfort and resolves to taking 
sod.bicarb (ENO) or alkali gels (DIGENE, GELUSIL). Is then the efficacy of 
PPI affected?

Secondly, a majority of patients in govt. hosp are too poor to buy their 
meals; won't then a combination (as I thought of) of PPI+H2 blocker a novel 
idea? can't we prescribe PPI for two days a week and H2 blocker on the rest 
of the days? (Famotidine 40 mg, once a day, costs around Rs.4.00 for 14 
tablets.........and cost of PPI, we all know).

The most fantastic part of PPI, as I feel is the isomerisation....which 
makes them actively concentrated in the acid producing cell. Can you tell me 
how (not the molecular part, of course) and where does this isomerisation 
occur? Since the begining, I used to think that acidity reducing (pH 
raising) agents will not allow PPI to be isomerised, is it so?

Regards,
Pranav
P.S. Thinking is useless unless there are good scores on the card!

Medical Graduate
Delhi
"Pranav Gupta" <pranavgupta@hotmail.com>