Talk:Esomeprazole

What

What I have drawn is, actually, the correct structure of S-omeprazole. The S designation of this molecule is with respect to its structure in vivo - where the sulfinyl moiety is ionised, and there is an additional hydrogen substituent off the chiral sulfur. Under these circumstances the stereochemistry is clearly S. So whilst, technically, this drawing may be R, it actually does represent the structure of S-omeprazole.Techelf 11:14, 21 Oct 2004 (UTC)

I do not agree. Omeprazole is the compound we have in the Nexium bottle. The formula here represents R-omaprazole, therefore it should be fixed. You might make a mistake when redrawing the formula, you pribably did functional group/molecule rotations and have forgotten to follow this motion and change the stereo bond type. Try to imagine the molecule in 3D-space :). If I'm wrong (I'm almost sure I'm not) please give me some reasonable explanation. Regards, Mykhal 14:33, 22 Oct 2004 (UTC)

I concede the point and have revised the drawing accordingly. I had initially (wrongly) supposed that the orientation of the substituents off the chiral sulfur was of a trigonal planar configuration; therefore I had assumed that the orientation of the oxygen substituent would not make a difference. In retrospect, I've realised that the sulfur substituents have a tetrahedral configuration; so you are right about the oxygen substituent being inverted - well spotted. Techelf 06:46, 23 Oct 2004 (UTC)

Thank you. I know, this is not obvious, that on the sulfur atom is lone electron pair which is the fourth "substituent" with lowest priority.. Mykhal 08:49, 23 Oct 2004 (UTC)

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The following information from the DrugBank should be incorporated (not copied!) into this article:
"Esomeprazole is a compound that inhibits gastric acid secretion and is indicated in the treatment of gastroesophageal reflux disease (GERD), the healing of erosive esophagitis, and H. pylori eradication to reduce the risk of duodenal ulcer recurrence. Esomeprazole belongs to a new class of antisecretory compounds, the substituted benzimidazoles, that do not exhibit anticholinergic or H2 histamine antagonistic properties, but that suppress gastric acid secretion by specific inhibition of the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell. Because this enzyme system is regarded as the acid (proton) pump within the gastric mucosa, Esomeprazole has been characterized as a gastric acid-pump inhibitor, in that it blocks the final step of acid production. This effect is dose-related and leads to inhibition of both basal and stimulated acid secretion irrespective of the stimulus." [1]

I'll probably do it myself eventually, if no one else does. Fuzzform 02:13, 22 February 2006 (UTC)

AstraZeneca is teh Evil

Esomeprazole, given the brand name Nexium is a product of the larger corporation AstraZeneca. Nexium is one of twelve other key products that AstraZeneca produces. AstraZeneca’s corporate headquarters is run out of London, England along with a U.S. headquarters in Wilmington, Delaware. AstraZeneca is a major corporation which supports 64,000 employees worldwide with 12,000 from the United States. Thus, making AstraZeneca an influential part of the U.S. economy. To prove this point, in 2005 alone, AstraZeneca made 23.9 billion dollars in sales. (AstraZeneca Pharmaceuticals LP, http://www.astrazeneca-us.com/content/aboutUs/keyFacts.asp) The reason for the success of AstraZeneca is due to its quality workers, research, and production. A number of awards have even been given out to AstraZeneca, including its product of the year achievement and Top 50 Employer award. (AstraZeneca Pharmaceuticals LP, http://www.astrazeneca-us.com/content/aboutUs/awards.asp) These two awards are an example of the efficiency and quality of work that AstraZeneca runs on. There are several other businesses which depend on AstraZeneca. These include Contact Information Centers, Research and Development Facilities, Supply Sites, and Business Centers. (http://www.astrazeneca-us.com/content/aboutUs/usLocations.asp) All of these businesses undoubtedly have even smaller businesses depending on them. As mentioned earlier, several thousands of Americans depend on AstraZeneca for work. Overall, AstraZeneca is a corporation that supports and is depended on by a lot of other small business and individuals. It is another example of one of the many corporations that makes the U.S. economy work.

Sources:

AstraZeneca LP http://www.astrazeneca-us.com/content/aboutUs/keyFacts.asp AstraZeneca LP http://www.astrazeneca-us.com/content/aboutUs/awards.asp AstraZeneca LP http://www.astrazeneca-us.com/content/aboutUs/usLocations.asp —Preceding unsigned comment added by JKsung (talk • contribs)

What exactly is the point of this, other than advertising AstraZeneca? I am glad you added it to the talk page instead of the article though, and certainly hope you are not intending to do so. If no editors object, I will remove this comment within 24 hours. Fvasconcellos 23:40, 27 October 2006 (UTC)

Reverting edits

With all of the citations that I provided -- please provide a rationale as to why you keep reverting text which enhances this information? —Preceding unsigned comment added by Chrisgaffneymd (talk • contribs)

I have replied on your talk page. Fvasconcellos 00:35, 28 October 2006 (UTC)

Use of Nexium over a period of five years and Prilosec before that...

With documented severe reflux, "nutcracker esophagus" and on esophageal manometry and ph testing noted to have vomiting of stomach acid and food with severe chest pain indistinguishable from my angina when not taking Nexium (and no other medicine worked)--I could no longer afford to buy this drug. By doing research into "natural methods" of controlling this problem--by this time thoroughly disgusted with the high cost of caring for this disorder by normal "medical means", I found a number of "natural methods" that worked perfectly well--when only Nexium at over $400/mo (twice a day) would work of the allepathic methods. I am currently saving myself about $350/mo in cost this way--and it is all much more pleasant by far. Yes, I have to watch my diet--but I certainly feel better!---- —Preceding unsigned comment added by 71.36.41.163 (talk) 22:41, 11 June 2008 (UTC)

Interaction with other drugs, e.g. SSRIs?

I have noticed that Esomeprazole shares metabolic mechanisms with other drugs such as Clonazepam, and SSRIs like Escitalopram and Citalopram. Can someone look up if there is expected to be heightened serum levels of these drugs while on Esomeprazole due to their shared hepatic clearance mechanisms? If so, I think this should be included in this article. Please include with a source. --1000Faces (talk) 16:16, 1 December 2009 (UTC)

Done. Fvasconcellos (t·c) 18:49, 1 December 2009 (UTC)

Dosage equivalency with omeprazole?

Is there any literature which cites the dosage equivalency of omeprazole to Esomeprazole? For example, if someone were to switch from 40mg of Esomeprazole, should they switch to 10, 20, 40, or 80mg of omeprazole? If there is data in the literature on this, I think it should be mentioned here. It is touched upon during the Controversy segment, but lacks conclusive statements. --1000Faces (talk) 04:25, 2 December 2009 (UTC)

Poor metabolizers?

The Prilosec article states that: "In theory, by using pure esomeprazole the effect on the proton pump will be equal in all patients, eliminating the poor metabolizer effect." Can this be explained here with citations? It has been mentioned in this article that overcoming individual differences was a reason for developing this drug, but is this what is meant? More clarity is needed. --1000Faces (talk) 15:20, 24 December 2009 (UTC)