Medication Strategies for Hea... Video Transcript

Webcast Transcript

We would tell patients, "Gee, if you get heartburn, take an antacid, and if you want to prevent it, take the H2 blocker." So we often did that. Now there certainly is a medication today that combines the two. Pepcid complete has both antacid and an H2 blocker.

ANNOUNCER: H2 blockers prevent one of the messenger signals from getting to the parietal cell. There's another class of drugs that attack acid formation at another stage in the process, at structures in the parietal cells called proton pumps. The drugs are called Proton Pump Inhibitors, or PPI's.

STEVEN PEIKIN, MD: The PPIs, the so-called PPIs, work because they block the final pathway that makes acid. All the three different mechanisms: histamine, gastrin and acetylcholine work through the proton pump. It pumps up an acid ion into the stomach and brings back potassium into the cell. This pump that pumps acid into the stomach is blocked by the proton pump inhibitors.

So the PPIs, like Aciphex, Protonix, Nexium and Prilosec, these are drugs that bind and knockout the proton pump.

HASHEM EL-SERAG, MD: The onset of action of a proton pump inhibitor is also delayed, so it doesn't start working 'till approximately one hour after ingestion. But once you take it, it blocks the acid production for really extended periods of time, anywhere from 10 to 16 hours.

ANNOUNCER: Consumers have many choices in heartburn medicines. But when should they seek the advice of a doctor?

STEVE PEIKIN, MD: If somebody has trouble swallowing, burning in their esophagus when they swallow, somebody who is choking at nighttime, somebody who has frequent coughing at nighttime, somebody who has black, tarry stools -- those are alarm symptoms. That person needs to see their doctor and be evaluated.

Without those alarm symptoms, and when symptoms don't last longer than a month, doctors say a world of relief is available on supermarket shelves and at the corner drug store.

HASHEM EL-SERAG, MD: Over-the-counter medications are generally effective for dealing with heartburn. The majority of sufferers of heartburn are those who suffer from infrequent, episodic heartburn, they know hat brings it on and they know what relieves it. For those patients, over-the-counter medications are usually effective.

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