5-PATHOGENESIS
PPIs include omeprazole, pantoprazole, esomeprazole, lansoprazole,
rabeprazole, and the newer dexlansoprazole and tenatoprazole. They have
a common chemical structure, represented by a benzimidazole ring plus a
pyridine ring, varying only in the side chain substituted on both
moieties. Omeprazole and pantoprazole have, respectively, a methoxy and
a difluoromethoxy chain in their benzimidazole rings, whereas
lansoprazole and rabeprazole modify the pyridine ring where the
trifluoroethoxy and methoxypropoxy chains are located respectively.
Tenatoprazole is the only one with an imidazopyridine, instead of a
benzimidazole, ring structure, responsible for a longer half-life of the
drug compared to other PPIs.2,32,33