Pantoprazole Pharmacodynamics
Mechanism of action
Pantoprazole affects the generation of stomach acid by attaching to the H+/K+ ATP pump of the stomach’s gastric parietal cell, which impedes gastric and basal acid output (Protonix Clinical Pharmacology, n.d.).
Adverse reactions
The adverse impact may present itself as “acute tubulointerstitial nephritis, clostridium difficile-associated diarrhea, bone fracture, severe cutaneous adverse reactions, cutaneous and systemic lupus erythematosus” (Protonix Clinical Pharmacology, n.d., para. 32). Reactions also include cyanocobalamin (Vitamin B-12) deficiency hypomagnesemia and mineral metabolism, and fundic gland polyps (Protonix Clinical Pharmacology, n.d.).
Pantoprazole Pharmacokinetics
Absorption
Pantoprazole is absorbed through oral administration as an enteric-coated tablet, as it peak concentration is reached in 2-3 hours with a bioavailability of 77% that does not alter with successive doses (Pantoprazole, n.d.). The Cmax after a 40mg oral application is approximately 2.5 g/mL, with a max of 2 to 3 hours, around 5 g.h/mL is the AUC (Pantoprazole, n.d.).
Distribution
Pantoprazole’s apparent volume of distribution ranges from 11 to 23.6 L, predominantly in the extracellular fluid (Pantoprazole, n.d.). Pantoprazole attaches to around 98% of serum proteins, mainly albumin (Pantoprazole, n.d.).
Metabolism
The cytochrome P450 (CYP) system metabolizes pantoprazole extensively in the liver. The major metabolic process is demethylation by the hepatic cytochrome enzyme CYP2C19, followed by sulfation; additional metabolic pathways involve CYP3A4 oxidation (Protonix Clinical Pharmacology, n.d.).
Excretion
Seventy-one percent of a single dose of 14C-labeled pantoprazole leaves the organism via urine, while eighteen percent is excreted through biliary excretion (Protonix Clinical Pharmacology, n.d).
Patient Education
It is crucial to keep patients informed regarding this drug and its proper application. People must realize possible adverse reactions since their organs may be damaged from the long-term use or improper dosages of Protonix (Pantoprazole, n.d.). Furthermore, one’s knowledge of their history of diseases is critical during such a treatment. Before taking pantoprazole, the patient should report if they have or have ever had liver diseases or lupus (Moayyedi et al., 2019). Patients must be knowledgeable regarding their chemical imbalances, which can be worsened by this drug and produce adverse effects. The expected medication period before improvements become evident is eight weeks, during which patients must take Protonix in prescribed dosages (Dabrowski et al., 2018). By knowing what detrimental impact can be made by this drug, an individual can alleviate this damage through supplements recommended by their healthcare provider.
References
Moayyedi, P., Eikelboom, J. W., Bosch, J., Connolly, S. J., Dyal, L., Shestakovska, O. & COMPASS Investigators. (2019). Pantoprazole to prevent gastroduodenal events in patients receiving rivaroxaban and/or aspirin in a randomized, double-blind, placebo-controlled trial. Gastroenterology, 157(2), 403–412. Web.
Dabrowski, A., Štabuc, B., & Lazebnik, L. (2018). Meta-analysis of the efficacy and safety of pantoprazole in the treatment and symptom relief of patients with gastroesophageal reflux disease – PAN-STAR. Gastroenterology Review, 13(1), 6–15. Web.
Pantoprazole. (n.d.). DrugBank Online. Web.
Protonix Clinical Pharmacology. (n.d.). Pfizer Medical Information. Web.