Assuntos
Antiulcerosos/história , Refluxo Gastroesofágico/história , Antagonistas dos Receptores Histamínicos/história , Úlcera Péptica/história , Inibidores da Bomba de Prótons/história , Antibacterianos/história , Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Quimioterapia Combinada , Ácido Gástrico/metabolismo , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/etiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/história , Helicobacter pylori , Antagonistas dos Receptores Histamínicos/uso terapêutico , História do Século XX , Humanos , Omeprazol/história , Omeprazol/uso terapêutico , Úlcera Péptica/tratamento farmacológico , Úlcera Péptica/etiologia , Úlcera Péptica/microbiologia , Inibidores da Bomba de Prótons/uso terapêutico , Estados UnidosRESUMO
Gastroesophageal reflux disease (GERD) has evolved from a scarcely reported, little understood disease process just a century ago to a now highly prevalent disease with up to 25% of the population complaining of symptoms of reflux. Throughout history attempts have been made to delineate the esophagus and related pathologies, but it has not been until relatively recently that enough has been understood about its screening, diagnosis and treatment to make a substantial impact on sufferers. Although the use of antacids and thereafter histamine 2 receptor antagonists dramatically improved the management of GERD, it was the advent of the proton pump inhibitor (PPI) class of drugs that revolutionized medical care. Although the relationship of hiatus hernia to reflux was well accepted, the modest results of open fundoplication fell into further disregard given the efficacy of PPIs. The PPIs are currently the most effective form of therapy and are equivalent on a milligram for milligram basis. While currently no novel drugs or devices are of proven efficacy for GERD, the development of an acid-suppressive agent of equal efficiency to a PPI but with a more rapid onset of action and a greater duration of effectiveness would be of particular clinical utility for the future.
Assuntos
Antiulcerosos/história , Benzimidazóis/história , Refluxo Gastroesofágico/história , Omeprazol/história , Sulfóxidos/história , 2-Piridinilmetilsulfinilbenzimidazóis , Antiulcerosos/uso terapêutico , Benzimidazóis/uso terapêutico , Esofagite Péptica/história , Esofagite Péptica/terapia , Refluxo Gastroesofágico/terapia , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Omeprazol/uso terapêutico , Pantoprazol , Complicações Pós-Operatórias , Inibidores da Bomba de Prótons , Sulfóxidos/uso terapêuticoRESUMO
Block buster drugs share a variety of common features, among which is the tendency to create entirely new markets. For example, an early "informed" estimate of the potential market size for the hypothetically "perfect" peptic ulcer drug was thirty-five million dollars. Based on current sales, however, we reckon this hypothesis to have underestimated the actual market demand for omeprazole (Prilosec) by about 400-fold. Similarly, prior to the introduction of the "retired" block busters chlordiazepoxide and diazepam (Librium and Valium), the market for "minor tranquilizers" in the treatment of anxiety and neurosis did not exist. Thus, once an emerging block buster seems to be therapeutically working, it is not unusual for diagnostic rates of the disease for which it is indicated and efficacious to actually increase. Top block buster drugs generally have or appear to have a high margin of safety.
