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What is esomeprazole? Esomeprazole is the S-optical isomer of omeprazole and the world's first isomer proton pump inhibitor (PPI). It reduces gastric acid secretion by specifically inhibiting the proton pump of gastric parietal cells. Indicated for gastroesophageal reflux disease (GERD) - treatment of erosive reflux esophagitis - long-term maintenance treatment to prevent recurrence in patients with cured esophagitis - symptom control of gastroesophageal reflux disease (GERD) combined with appropriate antibacterial therapy to eradicate Helicobacter pylori, and - healing of duodenal ulcers associated with Helicobacter pylori infection - prevention of recurrence of peptic ulcers associated with Helicobacter pylori infection.

Esomeprazole (Nexium) can reduce gastric acid secretion by inhibiting specific proton pumps, and has a good inhibitory effect on both basic gastric acid secretion and stimulated gastric acid secretion. The mechanism of action of esomeprazole is the same as that of omeprazole, that is, when protonated under acidic conditions, esomeprazole is converted into a compound sulfenamide that inhibits the activity of H+/K+-ATPase. It quickly combines with the sulfhydryl group of cysteine ​​on the H+/K+-ATPase to form a disulfide bond, thereby inactivating the enzyme, specifically inhibiting the activity of H+/K+-ATPase in gastric parietal cells and thus inhibiting gastric acid secretion.

Research shows that the acid-suppressing ability of esomeprazole for injection is faster and more effective than other injectable PPIs. Dirk et al. gave healthy volunteers a single intravenous dose of 40 mg esomeprazole (Nexium) or 40 mg pantoprazole, and then continuously monitored the intragastric pH and found that the duration of pH > 4 in the first 6 hours after administration in the two groups was 3.4 and 2.1 hours respectively, and the corresponding values ​​at 24 hours were 11.8 and 7.2 hours respectively. Research by Wilder et al. shows that at the same dose, repeated intravenous infusion of esomeprazole inhibits gastric acid faster and more effectively than pantoprazole.