‫‪#answer‬‬

‫ﺳﻮﺍﻝ ﺃﻣﺲ‬

‫‪Proton pump inhibitors Drugs (PPI) as Omeprazole :-‬‬

‫‪inhibit acid‬‬

‫‪Degradation by acid‬‬

‫‪Activation by acid‬‬

‫?‪How this happened explain‬‬

‫ﺍﻹﺟﺎﺑﺔ ‪ -:‬ﺍﻟﺴﻮﺍﻝ ﻫﺬﺍ ﺏ ﻳﻔﺘﺢ ﻋﻠﻴﻚ ﺍﺳﺄﻟﺔ ﻛﺜﻴﺮﺓ ﻭﺳﻮﻑ ﺗﻔﻬﻢ ﺃﺷﻴﺎﺀ ﻛﺜﻴﺮﺓ ﺟﺪﺍ ﻭﻣﻬﻤﺔ ‪.‬‬

‫ﺃﻭﻻ ﻧﺒﺪﺃ ﺑﺎﻝ ‪M.O.A of PPI‬‬

‫ﺍﻧﺖ ﺳﻮﻑ ﺗﺠﺪ ﺍﻟﻤﻜﺎﻧﻴﻜﻴﺔ ﺗﻘﻮﻝ ﻟﻚ‬

‫‪Irreversible inhibitions of proton pump ..‬‬

‫‪## inhibit of acid‬‬

‫ﺍﻳﺶ ﻳﻘﺼﺪ ﻓﻲ‬

‫‪Irreversible‬‬

‫‪..‬ﻭﺍﻳﺶ ﺗﻌﻨﻲ ﻫﺬﺓ ﺍﻟﻜﻠﻤﺔ‬

‫ﻳﻌﻨﻲ ﻏﻴﺮ ﻋﻜﺴﻲ ﺗﺮﺟﻤﺔ ﺣﺮﻓﻴﺔ‪.‬‬

‫ﺍﻳﺶ ﻳﻘﺼﺪ‬

‫ﻳﻘﺼﺪ ﺃﻥ ﺍﻟﻌﻼﺝ ﻛﺴﺮ ﻛﻞ‬

‫‪pump ..‬‬

‫ﻳﻌﻨﻲ ﺣﺘﻰ ﻟﻮ ﺍﻟﻌﻼﺝ ﺧﺮﺝ ﻣﻦ ﺍﻟﺠﺴﻢ‬

‫ﺍﻟﻔﻌﺎﻟﻴﺔ ﺏ ﺗﺠﻠﺲ ﺣﻖ ﺍﻟﺪﻭﺍﺀ ﻭﻫﺬﺍ ﺍﻟﺬﻱ ﺏ ﻳﻜﺸﻒ ﻟﻲ ﺍﻟﺴﻮﺍﻝ ﺍﻟﺸﻬﻴﺮ ﺍﻟﺬﻱ ﻳﺴﺄﻝ ﺍﻟﻨﺎﺱ‬

‫ﻛﻴﻒ ﻋﺎﺋﻠﺔ ‪ PPI‬ﺗﺠﻠﺲ ﻓﻌﺎﻟﻴﺘﻬﺎ ﻟﻤﺪة ﻳﻮم أو ﻳﻮﻣﻴﻦ ﻣﻊ أن ‪ half life‬ﺣﻖ اﻟﺪواء ﺗﺼﻞ إﻟﻰ ﺳﺎﻋﺔ ﻓﻘﻂ ‪..‬‬

‫ﺃﻗﻮﻝ ﻟﻚ ‪ Irreversible‬ﻳﻌﻨﻲ ﻟﺔ ﺗﺄﺛﻴﺮ ﺍﻟﺪﻭﺍﺀ ﻭﻟﻮ ﺧﺮﺝ ﻣﻦ ﺍﻟﺠﺴﻢ ‪..‬‬

‫ﺍﻟﺪﻭﺍﺀ ﻛﺴﺮ ﻛﻞ ‪ pump‬ﺍﻟﺬﻱ ﺗﺨﺮﺝ ﺍﻟﺤﻤﺾ ‪ ..‬ﻳﻌﻨﻲ ﺍﻟﺠﺴﻢ ﻳﺤﺘﺎﺝ ﺇﻟﻰ ﻳﻮﻡ ﺃﻭ ﻳﻮﻣﻴﻦ ﻟﻌﻤﻞ ‪ pump‬ﺟﺪﻳﺪﺓ ‪..‬‬

‫‪ ##‬ﺫﻛﺮﺕ ﺍﻧﺎ ﻓﻲ ﺍﻟﺴﻮﺍﻝ ﺍﻧﺔ‬

‫‪Activition by acid‬‬

‫‪..‬‬

‫ﻗﺒﻞ ﻣﺎ ﺃﺟﻴﺐ ﻋﻠﻰ ﺍﻟﺴﻮﺍﻝ ﺧﻠﻴﻨﻲ ﺍﻋﻄﻴﻚ ﺍﻟﻤﻌﻠﻮﻣﺔ ﺍﻟﻤﻬﻤﺔ ‪..‬‬

‫ﻧﺤﻦ ﻧﻌﺮﻑ ﺃﻥ ﺍﺫﺍ ﻣﻌﺎﻙ ﺩﻭﺍﺀ ﺣﻤﻀﻲ ﻣﻌﻈﻤﻬﺎ ﺏ ﺗﻤﺘﺺ ﻓﻲ ﺍﻟﻤﻌﺪﺓ ﻷﻥ ﺍﻟﻤﻌﺪﺓ ﺣﻤﻀﻴﺔ‬

‫‪:-‬ﻳﻌﻨﻲ ﻫﺬﺓ ‪ role‬ﺍﺣﻔﻈﻬﺎ ﻫﻜﺬﺍ‬

‫ﺍﻟﺪﻭﺍﺀ ﻓﻲ ﻧﻔﺲ ﻭﺳﻄﻪ ﻳﻜﻮﻥ ‪ Non ionized‬ﻏﻴﺮ ﻣﺘﺄﻳﻦ ﻳﻌﻨﻲ ﺏ ﻳﻤﺘﺺ ‪..‬‬

‫ﺃﻣﺎ ﺇﺫﺍ ﻛﺎﻥ ﺍﻟﺪﻭﺍﺀ ﻓﻲ ﻋﻜﺲ ﻭﺳﻄﺔ ﻳﻜﻮﻥ ‪ ionized‬ﻣﺘﺄﻳﻦ ﻳﻌﻨﻲ ﻣﺎ ﻳﻤﺘﺺ ‪..‬‬

‫ﻋﻼﺟﺎﺕ ‪ PPI‬ﻫﻴﺎ ‪ weak base‬ﻳﻌﻨﻲ ﻗﺎﻋﺪﻳﺔ ﻳﻌﻨﻲ ﺏ ﺗﻤﺘﺺ ﻓﻲ ﺍﻷﻣﻌﺎﺀ‬

‫ﻷﻥ ﺍﻟﺪﻭﺍﺀ ﺍﻟﻘﺎﻋﺪﻱ ﻓﻲ ﺍﻷﻣﻌﺎﺀ ﺍﻟﺬﻱ ﻫﻮﺓ ﻗﺎﻋﺪﻱ ﺏ ﻳﻜﻮﻥ ‪ Non ionized‬ﻏﻴﺮ ﻣﺘﺄﻳﻦ ﻳﻌﻨﻲ ﺏ ﻳﻤﺘﺺ ﻣﻦ ﺍﻷﻣﻌﺎﺀ ﺇﻟﻰ ﺍﻟﺪﻡ‬

‫ﺍﻟﺪﻡ ‪ PH‬ﺣﻘﺔ ‪ 7.4‬ﻳﻌﻨﻲ ﻳﻤﻴﻞ ﺇﻟﻰ ﺍﻟﻘﺎﻋﺪﻳﺔ ﻳﻌﻨﻲ ﺍﻟﺪﻭﺍﺀ ﻓﻲ ﺍﻟﺪﻡ‬

‫‪Non ionized‬‬

‫ﺍﺫﺍ ﺍﻟﺪﻡ ﻳﻮﺯﻋﺔ ﺇﻟﻰ ﺟﻤﻴﻊ ﺃﻧﺤﺎﺀ ﺍﻟﺠﺴﻢ ﻳﺮﺟﻊ ﻳﺪﺧﻞ ﺍﻟﻤﻌﺪﺓ ‪《-‬ﺩﺧﻞ ﺇﻟﻰ ‪ parietal cells‬ﺃﺳﺄﻝ ﻧﻔﺴﻚ ﺩﺍﺧﻞ ﺍﻟﺨﻠﻴﺔ ﺍﻟﻮﺳﻂ ﻗﺎﻋﺪﻱ ﺃﻭ‬
‫ﺍﻟﻮﺳﻂ ﺣﻤﻀﻲ‬

‫‪ ...‬ﺏ ﺗﻌﺮﻑ ﺃﻥ ﺍﻟﻮﺳﻂ ﻳﻤﻴﻞ ﺇﻟﻰ ﺍﻟﻘﺎﻋﺪﻳﺔ ‪ <--‬ﻳﺮﺟﻊ ﺍﻟﺪﻭﺍﺀ ﻳﺪﺧﻞ ﺇﻟﻰ ﺍﻷﻧﺎﺑﻴﺐ ‪ PUMP‬ﻭﺟﺪ ﺍﻷﻧﺎﺑﻴﺐ ‪acid‬‬

‫ﺍﻟﻌﻼﺝ ‪ base‬ﻭ ﺍﻷﻧﺎﺑﻴﺐ ‪ acid‬ﺍﺫﺁ‬

‫ﺗﺄﻳﻦ ‪Ionized‬‬

‫ﻳﻌﻨﻲ ﺍﻟﻌﻼﺝ ﺍﺣﺘﺠﺰ ﻓﻲ ﻫﺬﺓ ﺍﻷﻧﺎﺑﻴﺐ‬

‫ﻳﻌﻨﻲ ﻫﺬﺍ ﺍﻟﻜﻼﻡ ﺃﻥ ﻫﺬﺍ ﺍﻟﺪﻭﺍﺀ‬

‫‪Selective in parietal cells‬‬

‫‪ ##‬ﻳﻌﻨﻲ ﻭﻗﻊ ﻟﻠﺪﻭﺍﺀ ‪ ACTIVITION‬ﺃﻭ ﻻ ‪ ....‬ﺍﻛﻴﺪ ﻭﻗﻊ ﻟﺔ ‪ ACTIVITION‬ﺑﻮﺍﺳﻄﺔ ﺍﻳﺶ ﺑﻮﺍﺳﻄﺔ ﺍﻷﻧﺎﺑﻴﺐ ﺍﻟﺬﻱ ﻫﻴﺔ ﺣﻤﻀﻴﺔ ﻳﻌﻨﻲ ﺃﻥ‬
‫ﺣﺼﻞ ﻟﻠﺪﻭﺍﺀ‬

‫‪### ACTIVITION BY ACID‬‬

‫ﻭﻫﺬﺍ ﺍﻟﺴﻮﺍﻝ ‪Ӛ‬‬

‫ﺣﻠﻮ ‪ ...‬ﻭﻫﺬﺓ ﻣﻦ ﻣﻤﻴﺰﺍﺕ ﻫﺬﺓ ﺍﻟﻤﺠﻤﻮﻋﺔ ‪ ..‬ﻫﺬﺓ ﺍﻟﻌﻤﻠﻴﺔ ﺍﻟﺘﻰ ﺣﺼﻠﺖ ‪ ӓ ӓ‬ﺗﺴﻤﻰ ‪. ion Trapping‬‬

‫ﺣﻠﻮ ﺍﻟﻜﻼﻡ ﺇﻟﻰ ﺍﻵﻥ‬

‫ﺃﻧﺖ ﺏ ﺗﻘﻮﻝ ﺍﻧﺖ ﻗﻠﺖ ﺃﻥ ﺍﻟﺪﻭﺍﺀ‬

‫‪Degradation by acid ..‬‬

‫ﻧﻌﻢ ‪..‬‬

‫ﺍﻧﻈﺮ ﺍﻧﺖ ﺇﻟﻰ ‪ Omeprazole‬ﻣﺜﻼ ﺏ ﺗﺤﺼﻞ ﺍﻟﻌﻼﺝ ﻣﻜﺘﻮﺏ ﺟﻨﺒﺔ ﺃﻥ ﺍﻟﻌﻼﺝ‬

‫‪Entric Coated‬‬

‫ﻣﺼﻄﻠﺢ ‪ Entric‬ﺟﺎﺀ ﻣﻦ ‪ intestine‬ﺍﻷﻣﻌﺎﺀ‬

‫اذا ﻳﺸﺘﻲ ﻳﻘﻮﻝ ﻟﻚ ﻫﺬﺓ ﺍﻷﺩﻭﻳﺔ ‪Entric Coated‬‬

‫ﺗﻔﺘﺢ ﻓﻲ ‪.. intestine‬‬

‫ﺇﺫﺍ ﺃﻧﺖ ﺏ ﺗﻘﻮﻝ ﺍﻟﺪﻭﺍﺀ ﺣﻘﻲ ﺏ ﻳﻤﺘﺺ ﺍﺻﻼ ﻓﻲ ﺍﻷﻣﻌﺎﺀ ﻟﻴﺶ ﻋﺎﺩ ﺍﻧﺎ ﻣﺤﺘﺎﺝ ﻫﺬﺍ ﺍﻟ??? ‪؉ ؉ ؉ ؉‬‬

‫ﺑﺲ ﺏ ﺗﻌﺮﻑ ﺃﻥ ﺍﻟﺪﻭﺍﺀ ﻳﺘﻜﺴﺮ ﻓﻲ ﺍﻟﻤﻌﺪﺓ‬

‫ﺣﺘﻰ ﻭﻟﻮ ﻫﻮﺓ ﺣﺘﻰ‬

‫‪Base‬‬

‫ﻟﺬﺍﻟﻚ ﺍﻟﻐﻼﻑ ﻫﺬﺍ ﻳﺤﻤﻴﺔ ﻟﻜﻲ ﻻ ﻳﺘﻜﺴﺮ ﻓﻲ ﺣﻤﻮﺿﺔ ﺍﻟﻤﻌﺪﺓ ‪..‬‬

‫ﺍﻹﺟﺎﺑﺔ ﺏ ﺍﺧﺘﺼﺎﺭ ﻷﻥ ﺣﻤﻮﺿﺔ ﺍﻟﻤﻌﺪﺓ ﺏ ﺗﻜﺴﺮ ﺍﻟﺪﻭﺍﺀ‬

‫‪##Degradation BY acid‬‬

‫ﺣﺒﻴﻨﺎ ﻧﻄﻮل ﻓﻲ ﺣﺎﺟﺎت ﻣﻬﻤﻪ ﺣﺘﻰ ﻟﻮ ﻛﺎﻧﺖ اﻹﺟﺎﺑﺔ ﺑﺎﺧﺘﺼﺎر ﺗﻜﻔﻲ و أﻋﻄﻴﻨﺎ أﺳﺄﻟﻪ زﻳﺎدة ﻟﻜﻲ ﺗﺄﺧﺬ ﻫﺬة اﻟﻤﻌﻠﻮﻣﺎت ﻋﻠﻰ‬
‫‪Proton pump inhibitors .‬‬

‫ﺃﺳﺌﻠﺔ ﺍﻟﻘﻨﺎﺓ ﺗﺸﻴﺮ ﺇﻟﻰ ﺍﻟﺠﺎﻧﺐ ﺍﻟﻔﻬﻢ ﻭﻟﻴﺲ ﺍﻟﻨﺴﺦ ﻭﺍﻟﺼﻖ ﻣﺜﻞ ﺃﻛﺜﺮ ﺍﻟﻤﺠﻤﻮﻋﺎﺕ ﻭ ﺍﻷﺳﺌﻠﺔ ﺍﻟﺘﻲ ﻓﻲ ﺍﻟﻘﻨﺎﺓ ﺃﺳﺌﻠﺔ ﻣﺜﻴﺮﺓ ﻭ ﻻ ﺗﻨﺴﻰ ‪..‬‬

‫ﻫﺬﺓ ﺍﻟﻔﻘﺮﺍﺕ ﺃﻥ ﺷﺎﺀ ﷲ ﺗﻌﺎﻟﻰ ﻷﻥ ﺗﻨﺴﻰ ﻟﻚ‬

‫ﻭ ﺗﺤﻴﺎﺗﻲ ﺃﺧﻮﻛﻢ ﺣﺴﺎﻡ ﺍﻟﺪﻳﻦ ﺍﻟﺤﻴﻔﻲ‬