April 1987

Advances in Drug Therapy for Peptic Ulcer Disease

Author Affiliations

From the Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston (Dr Pappas); the Department of Surgery, UCLA Medical Center (Dr Mulvihill); and the Department of Surgery, University of Washington Medical Center, Seattle (Drs Goto and Debas).

Arch Surg. 1987;122(4):447-450. doi:10.1001/archsurg.1987.01400160073011

• Recently, three new drug types have emerged to treat peptic ulceration. We compared the mechanism of action of omeprazole and somatostatin-14, both inhibitors of gastric acid, with that of tetraprenylacetone, a drug thought to be cytoprotective in the upper gut. Omeprazole and somatostatin-14 caused potent inhibition of meal-stimulated acid secretion in the dog (92% ± 6% and 97% ±1%, respectively). On the other hand, tetraprenylacetone had no significant inhibitory effect on acid secretion (4%±17%). In separate studies, tetraprenylacetone was shown to be a stimulant of gastric bicarbonate secretion in the rabbit, increasing bicarbonate secretion from a basal level of 0 to 86±28 pmol/2 h. Tetraprenylacetone was also found to be a strong stimulant of canine pancreatic bicarbonate secretion. The ability of tetraprenylacetone to stimulate endogenous bicarbonate secretion may explain its ability to heal ulcers both experimentally and clinically.

(Arch Surg 1987;122:447-450)