PUD KIT n o i e t l a n p c i i o r ed ti T A M dica . y a s r p r e E a c r e e l Th or th of U f
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PUD KIT
A Triple Therapy M
WHAT IS PUD KIT ?
ESOMEPRAZOLE
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PUD KIT is a triple therapy medication for the eradication of ulcers.
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Most persistent and recurrent Ulcers are as a result of H.Pylori and not just excessive gut acidity.
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H. Pylori induced ulcers cannot be eradicated by the use of just PPIs thus research necessitated the addition of a course of antibiotics to the treatment regimen over a period of time.
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Healing of reflux esophagitis is directly correlated with the intragastric pH > 4.0 (Holloway et al., 1996, Johansson et al., 1986).
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Patients who received esomeprazole in both one dose and continuous therapy were seen to maintain a pH greater than 4 longer than any other proton pump inhibitor over a 24hour period. (Bell and Hunt, 1992)
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On day 1, the percentage efficacy in all four studies read thus;
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Esomeprazole-40.6% VS Lansoprazole 33.4% (P=0.012) Esomeprazole-50.3% VS Pantoprazole 29.1% (P<0.001) Esomeprazole 41.0% VS Rabeprazole 29.4% (P=0.002) For the 5-day period; Esomeprazole 57.7% VS Lansoprazole 44.5% (P<0.0001) Esomeprazole 69.8% VS Omeprazole 43.7% (P<0.0001) Esomeprazole 67.0% VS Pantoprazole 44.8% (P<0.001) Esomeprazole 59.4% VS Rabeprazole 44.5% (P<0.0001).
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What does PUD KIT contain?
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PUD KIT is presented as a twice daily regimen for 7 days.
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One tab of Esomeprazole 40mg to be taken twice daily.
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One tab of Clarithromycin 250mg to be taken twice daily
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One tab of Tinidazole 500mg to be taken twice daily.
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Why PUD KIT? v
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Following extensive research into both populace and percentage of treatment success, PUD KIT was designed to overcome some of the challenges encountered in use of other medications for triple therapy such as metronidazole, omeprazole and amoxicillin. A detailed but brief slide as to why the combination of Esomeprazole, Tinidazole and Clarithromycin (standardized doses) are the best suited will thus be shown.
TINIDAZOLE v
Tinidazole is a nitroimidazole, a metronidazole-like antimicrobial agent
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It has a high efficacy against protozoa and anaerobic organisms, including H.Pylori.
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A strong reason why Tinidazole was used is because its actvities are largely independent of pH, thus allowing it thrive greatly in the treatment of gastric infections,and by extension, H.Pylori.
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The steady-state serum concentration of tinidazole following oral administration is higher than that of metronidazole (mattila et al., 1983)
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Better pharmacokinetic and pharmacodynamic profile
ESOMEPRAZOLE v
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Another study carried out by Rhi Nan Zheng (2009), on the subject matter of the symptomatic relief capacity of esomeprazole compared with other PPIs showed that esomeprazole had the ability to alleviate symptoms of Ulcer such as heartburns over a 24 hour period.
The proton pump inhibitors are a group of drugs that reduce the secretion of gastric acid in the stomach. These drugs act by binding H+K+ATPase, which is sometimes referred to as the proton pump.
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Better safety and tolerability
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This enzyme causes parietal cells of the stomach lining to produce acid.
Preserved activity against most Metronidazole-resistant bacteria
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Metronidazole,Secnidazole and Ornidazole all have alcoholic side chains, thus chances of cross resistance is high among these three compared to Tinidazole which has an entirely different side chain.
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Adverse effects due to metronidazole are frequent,this may lead to problems with adherence to a 7-day course of treatment and subsequently result in treatment failure.
A study carried out by Rohss et al., (2004) to see what PPI provides more intragastric acid control in patients with gastro-esophageal reflux disease proved favorable to the use of esomeprazole, both in one time therapy to provide relief and in prolonged therapy
Bakan Gizo UK Ltd, 12D Tuley Street Openshaw, Manchester M112DY. Bakan Gizo Nig. Ltd B13 A.M.A.C Office Complex Beside Heritage House Kabale Close, Wuze Zone 3, Abuja Tel: +2348 0345 40766, +2348 0779 9159 / www.bakangizo.com.ng
Medication for the Eradication of Ulcers. TINIDAZOLE v
The steady-state serum concentration of tinidazole following oral administration is higher than that of metronidazole (mattila et al., 1983)
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Better pharmacokinetic and pharmacodynamic profile
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Better safety and tolerability
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Preserved activity against most Metronidazole-resistant bacteria
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Metronidazole,Secnidazole and Ornidazole all have alcoholic side chains, thus chances of cross resistance is high among these three compared to Tinidazole which has an entirely different side chain.
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Adverse effects due to metronidazole are frequent,this may lead to problems with adherence to a 7-day course of treatment and subsequently result in treatment failure.
CLARITHROMYCIN v
Clarithromycin is a relatively new and well tolerated, acid stable macrolide antibiotic, that has a similar antimicrobial spectrum to erythromycin but better in vitro against H.pylori.
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Clarithromycin is a semi-synthetic macrolide antibiotic that acts by inhibiting the protein synthesis of H.Pylori by binding to the bacterial 50S ribosomal subunit.
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H.Pylori is a gram negative organism that survives in the deep mucus layer and attaches itself to the gastric surface cells
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Clarithromycin has a low minimum inhibitory concentration (MIC50) for H.Pylori and its effect is actually potentiated by acid inhibition
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Clarithromycin is well absorbed with a wide tissue distribution and mild side effects thus making it very useful in the cure and eradication of H.Pylori.
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Clarithromycin is thus a standard and effective drug that has a good therapeutic activity against H.Pylori, making it a â&#x20AC;&#x153;givenâ&#x20AC;? in any double, triple or quadruple therapy
All these facts put together make PUD KIT the drug of choice for the eradication of H.Pylori related ulcers.
...the unique combination for the eradication of PUD WHAT IS PUD KIT ? v
Bell NJ, Hunt RH. Role of gastric acid suppression in the treatment of gastro-oesophageal reflux disease. Gut. 1992;33:118–124.[PubMed]
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Holloway RH, Dent J, Narielvala F, Mackinnon AM. Relation between oesophageal acid exposure and healing of oesophagitis with omeprazole in patients with severe reflux oesophagitis. Gut. 1996;38:649–654.
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Miner P Jr, Katz PO, Chen Y, Sostek M. Reanalysis of intragastric pH results based on updated correction factors for Slimline and Zinetics 24 single-use pH catheters. Am J Gastroenterol. 2006;101:404–405; author reply 405-406.
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Rohss K, Wilder-Smith C, Naucler E, Jansson L. Esomeprazole 20mg provides more effective intragastric Acid control than maintenance-dose rabeprazole, lansoprazole or pantoprazole in healthy volunteers. Clin Drug Investig. 2004;24:1–7.
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Rohss K, Hasselgren G, Hedenstrom H. Effect of esomeprazole 40 mg vs omeprazole 40 mg on 24-hour intragastric pH in patients with symptoms of gastro-esophageal reflux disease. Dig Dis Sci. 2002;47:954–958.
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