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Gastric Acid (HCl) & Hyperacidity
Parietal Cell in
Stomach Lining Proton Pump
ATPase
Influence
Cl- K+ Acetylcholine
receptor
binds
binds
H = Histamine
A = Acetylcholine
G = Gastrin
Complications of Hyperacidity
Peptic ulcer
Gastric ulcer
Duodenal ulcer
Zollinger-Ellison Syndrome
Cancer
Complications of Hyperacidity
Antacid
Proton Pump Inhibitors (PPI)
Omeprazole
Lansoprazole
Pantoprazole
H2-receptor antagonist Esomeprazole
Ranitidine Rabeprazole
Famotidine
Roxatidine
Cimetidine
H2-receptor Antagonist: Servipep
Brand : Servipep
Generic : Famotidine
Dosage Form : Tablet
Strength : 20 mg & 40 mg
Therapeutic Class : Anti-ulcerant (H2-receptor antagonist)
Pack Size : Servipep 20mg tablet: 5x10’s
Servipep 40mg tablet: 5x10’s
Price : Servipep 20: 2.67 /tab & 133.50 /pack
Servipep 40: 5.06 /tab & 253.00 /pack
H2-receptor Antagonist: Servipep
Dosage
Cl- K+ Acetylcholine
receptor
-
Servipep
binds
binds
binds
H = Histamine
A = Acetylcholine
G = Gastrin
Proton Pump Inhibitor (PPI)
Proton pump inhibitors (PPI) are a group of drugs whose main action
is a pronounced and long-lasting reduction of gastric acid production.
Cl- K+ Acetylcholine
receptor
binds
binds
H = Histamine
A = Acetylcholine
G = Gastrin
Proton Pump Inhibitor (PPI)
Indication:
Omeprazole : Probitor®
Esomeprazole : Neptor®
Probitor
Brand : Probitor
Generic : Omeprazole
Strength : 20 mg & 40 mg
Peptic ulcer: 20 or 40mg once daily. 8 weeks for gastric ulcer & 4 weeks
of duodenal ulcer. 20mg once daily for long term maintenance dose.
GERD: 20-40mg once daily for 4-12 weeks. 20mg once daily as
maintenance dose.
Promotional activities:
Brand promotion – printed materials
Physician’s sample
Regular & innovative gimmick
Special gift
Special & innovative campaign (frequent)
Neptor
Brand : Neptor
Generic : Esomeprazole
Strength : 20 mg & 40 mg
GERD: 20 or 40mg once daily for 4-8 weeks. 20mg once daily as
maintenance dose.
Pediatric (>1year): 10 or 20mg for 1-11 yrs & 20 or 40mg for >11 yrs
once daily up to 8 weeks
Neptor
Dosage & Administration:
Side Effects:
Well tolerated. Nausea, vomiting, diarrhoea, constipation, abdominal pain,
flatulence and headache are common.
Drug Interactions:
Absorption of ketoconazole and itraconazole can decrease during
Esomeprazole treatment. When combined with diazepam, citalopram,
imipramine, clomipramine, and phenytoin the plasma concentration of these
drugs may be increased and a dose reduction could be needed. Concomitant
administration resulted in a 45% decrease in clearance of diazepam and 13%
increase in plasma level of phenytoin in epileptic patients.
Neptor: Key Selling Points
Only PPI that got the approval for children of 1 year & above
(Pantorpazole & Raberpazole are not recommended under 18 years)
Promotional activities:
Scientific promotion – printed materials, RTD
Physician’s sample
Regular & innovative gimmick
Special gift
Special & innovative campaign
TM
Tiemonium Methylsulphate
Brand : Zeum™
CNS
Release of different chemical mediators
(Acetylcholine, Histamine, etc.)
Smooth Muscle
Spasm / Pain
Mechanism: Zeum
Zeum…antispasmodic with a difference
Hyoscine / Scopolamine
- Passes the blood-brain-barrier & placental barrier
- Dependency develops, abuse potential
in divided doses
Use in Special Population Zeum
Safety & Tolerability:
Side effects are very rare.
It does not readily cross Blood-Brain-Barrier & therefore CNS
side effects are rare.
Unlike hyoscine, Tiemonium has no reported abuse potential.
Pregnancy & Lactation: In absence of sufficient data, yet not recommended. May be
used considering risk-benefit ratio.