Pharmacology for the gastrointestinal tract

Inhibidores de la bomba de protones en pediatría

In last years the use in the pediatric area of proton pump inhibitors (omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole) is more often, nevertheless the clinical trials carried out are poor. The aim of this work is to analyse the bibliography published about this kind of drugs in children and to make a revision of its use in the last seven years. More studies with omeprazole and lansoprazole have been developed, to be exact omeprazole and lansoprazole is present in 122 bibliographic appointments and 34 for lansoprazole, which include studies that demonstrate a good tolerance and efficacy. The remaining proton pump inhibitors count with very few studies. The main therapeutic indications were the eradication of Helicobacter pylori, gastroesophageal reflux disease and esophagitis. The number of patients included in the reviewed studies is quite heterogeneous, from 8 to 122 and the age range between 8 days and 17 years. On the other hand, it could be highlighted the non-existence of formulations adapted to the pediatric population and the difficulty of administration specially in the youngest patients. As in many other drugs, it would be necessary to carry out clinical trials in order to determinate the pharmacologic parameters at difference ages, which will allow a safe and effective administration, and its authorization by all Health Authorities.

Gastroesophageal reflux and histamine2 antagonists

GASTROESOPHAGEAL REFLUX (GER) IS THE RETROGRADE movement of the stomach contents into the esophagus, frequently caused by relaxation of the lower esophageal sphincter (LES). The pathophysiology of GER in neonates is not clear. However, many risk factors have been defined (Table 1).1Several developmental factors may influence the incidence of GER in neonates. Jadcherla suggests abdominal wall muscle tone, diaphragmatic activity, esophageal dysmotility, and LES tone as possible reasons for the prevelance of GER in the neonatal population.