GI: PPIs

Question 1

PPIs: INDICATIONS

Answer 1

• PUD
• GORD + DYSPEPSIA
• HP infection eradication - in conjunction AB THERAPY

Question 2

PPIs: MOA

Answer 2

• Reduce gastric acid secretion
• Irreversibly inhibiting H+/K+/ATPase proton pump in GASTRIC PARIETAL CELLS
• Targets final stage of gastric acid production is that they are able to suppress gastric acid production almost completely

Question 3

PPIs: ADVERSE EFFECTS

Answer 3

• GI disturbance
• Headache
• Increasing the gastric pH, PPIs reduce the bodys host defence against infection (C Difficile)
• Prolonged use = HYPOMAGNESAEMIA, lead to tetany and V Tach

Question 4

PPIs: WARNINGS

Answer 4

• Disguise the symptoms of gastric cancer, so prescribers should enquire about alarm symptoms BEFORE + DURING Tx
• High dose, long frequency = increased risk of fracture in the elderley
• @ risk patients of OSTEOPOROSIS should be identified

Question 5

PPIs: INTERACTIONS

Answer 5

• Omeprazole = decrease activation of cytochrome p450 enzymes
• REDUCES antiplatelet effect of CLOPIDOGREL
• LANSOPRAZOLE + PANTOPRAZOLE lower propensity to interact with CLOPIDOGREL, therefore these are the preferred PPIs prescribed alongside C

Question 6

PPIs: EXAMPLES

Answer 6

• LANSOPRAZOLE
• OMEPRAZOLE
• PANTOPRAZOLE