Lean production philosophy centers on the elimination of waste in all forms in the workplace. Specific lean methods include just-in-time inventory management, Kanban scheduling systems, 5S workplace organization, Scrum and other “agile” software development methodologies. Having a lean organizational structure is beneficial for businesses because lean principles aim to minimize all forms of waste, from sources as varied as material defects to worker ergonomics. Many sources of waste are easy to identify and correct, such as a machine that is out of adjustment, producing a high volume of defects. Beyond simply reducing costs and improving efficiency, lean production techniques introduce systems and develop skills with your staff that support changes in the workplace that new sales create.
ole is widely used proton pump inhibitor (PPIs) and it is a significant drug in the treatment of acid-related disorders [183] and biliary also effective against Helicobacter biliary infections alone or combined with other drugs, like metronidazole, clarithromycin or amoxicillin [184]. This drug was the first water soluble benzimidazole, sodium 5-(difluoromethoxy)-2-[[(3,4 – dimethoxy- 2- pyridinyl) methyl] sulfinyl]- 1H- benzimidazole sesquihydrate [185].
A molecule with benzimidazole substitution exhibits potent and long-lasting inhibition of gastric acid secretion by selectively interacting with the gastric proton pump (H+/K+-ATPase) in the parietal cell secretory membrane [183, 186].
The molecular formula is C16H14F2N3NaO4S×1. 5 H2O and molecular weight is 432.4 g/Mol[185]. Because of gradual degradation of pantoprazole sodium during heating, the melting point cannot be accurately determined. It is a white to off-white crystalline powder. The structural formula is: [185]
Pantoprazole has numerous advantages compared to its analogues (e.g., Omeprazole and lansoprazole) such as greater stability in a neutral PH environment, specific site of binding, and longer duration of action [187]. In addition, it shows no potential to either induce or inhibit the CYP 450 [183,184, 188]. It is a more selective inhibitor of acid secretion than other proton pump inhibitors [189].
Pantoprazole is used for treatment of erosive esophagitis, or “heartburn” caused by gatroesophageal reflux disease (GERD), a condition where the acid in the stomach washes back up into the esophagus. Pantoprazole can also be used to treat Zollinger-Ellison syndrome, a condition where the stomach produces too much acid.
The most common side effects of pantoprazole include blurred vision, dry mouth, abdominal pain, fatigue, flushed, dry skin, increased hunger, increased thirst, and increased urination. The other side effects are excess air or gas in either stomach or intestine and trouble in sleeping.
Mechanism of action:
In low PH values, pantoprazole is transformed into cationic sulfenamide, which is its active form [184, 190] , this drug accumulates in the highly acidic environment of the parietal-cell canalicular lumen and it is activated. The active form, tetracyclic cationic sulfonamide, reacts with thiol groups of cysteines 813 and 822 of transmembranal H+ / K+ ATPase[183, 186]. This conversion must take place beside the gastric parietal cells, so pantoprazole must be absorped intact by GIT [184].
The pantoprazole is an acid labile drug, which undergoes degradation in the stomach [191-194]. Therefore, the drug should be targeted to the intestine; to bypass the stomach. The gastro resistant drug delivery system is designed for the acid labile drugs due to the necessity to pass intact through the stomach for reaching the duodenum for absorption. The dosage form is prepared to bypass the stomach by formulating a solution for intravenous administration (lyophilized powder for reconstitution) or as gastric‐resistant tablets (oral delayed‐release dosage form) [195]. In the case of oral administration, the enteric coating prevents the drug from degradation in the gastric juice (at pH 1–2
