PPIs can be divided into two groups based on their basic structure. Although all members have a substituted pyridine part, one group has linked to various benzimidazoles, whereas the other has linked to a substituted imidazopyridine. All marketed PPIs (omeprazole, lansoprazole, pantoprazole) are in the benzimidazole group.
Proton pump inhibitors are prodrugs and their actual inhibitory form is somewhat controversial. In acidic solution, the sulfenic acid is isolated before reaction with one or more cysteines accessible from the luminar surface of the enzyme, a tetracyclic sulfenamide. This is a planar molecule thus any enantiomer of a PPI loses stereospecifity upon activation.
The effectiveness of these drugs derives from two factors: their target, the H/K ATPase which is responsible for the last step in acid secretion; therefore, their action on acid secretion is independent of the stimulus to acid secretion, of histamine, acetylcholine, or other yet to be discovered stimulants. In addition, their mechanism of action involves covalent binding of the activated drug to the enzyme, resulting in a duration of action that exceeds their plasma half-life.