Proton pump inhibitors: A balanced view

This book is the 32^nd volume of the ongoing series, Frontiers of Gastrointestinal Research and has been edited by three eminent personalities. The first chapter by Hiroshi Satoh traces the discovery and development of proton pump inhibitors (PPIs). The parent molecules for the drugs were thioacetamide derivatives, discovered almost simultaneously by two pharmaceutical companies, Takeda (Japan) and Servier (France). This chapter recounts how early toxicity in animals necessitated chemical modifications that led eventually to development and launch of omeprazole in 1988 by Astra and lansoprazole in 1991 by Takeda. The chapter goes on to follow developments till the present day. The pharmacokinetics, pharmacodynamics and pharmacogenetics of PPIs are comprehensively reviewed in the next chapter. Subsequent chapters deal with clinical applications, including tailoring of the dose to specific clinical conditions including gastroesophageal reflux disease (GERD), prevention and healing of non-steroidal analgesic-induced ulcers, and their role in eradication of Helicobacter pylori. The central role of parenteral or oral high dose PPIs in the management of bleeding peptic ulcer disease has been highlighted. The role of PPIs in functional dyspepsia, especially to relieve symptoms in undiagnosed gastroesophageal reflux disease has also been reviewed. Their supplementary use in the management of exocrine pancreatic insufficiency has been highlighted in the next chapter. Given the wide and somewhat indiscriminate use of PPIs, there is concern about their long term side effects. Both gastrointestinal and the systemic side effects of long term therapy of PPIs has been comprehensively dealt with in the last two chapters. In all, this is a compact and useful reference book that should find place in medical college and reference libraries.