PPIs

Question 1

What are the two examples of proton pump inhibitors?

Answer 1

omeprazole;
esomeprazole

These are commonly used medications that reduce stomach acid production.

Question 2

What is the mechanism of action for proton pump inhibitors?

Answer 2

Prodrugs undergo conversion to active form in parietal cells, causing irreversible inhibition of proton pump

Inhibits the** basal** release of hydrogen ions and the stimulated release of hydrogen ions

Question 3

What conditions are treated with proton pump inhibitors?

Answer 3

PUD, gastritis, esophagitis, GERD, esophageal bleeding

PUD stands for peptic ulcer disease.

Question 4

What effect do proton pump inhibitors have on asthma associated with GERD?

Answer 4

They alleviate asthma

GERD can cause bronchoconstriction, which may worsen asthma symptoms.

Question 5

What is a potential risk associated with proton pump inhibitors?

Answer 5

Increased risk of osteoporotic fractures due to calcium deficiency

Long-term use of PPIs can lead to decreased calcium absorption.

Question 6

What are some disadvantages of proton pump inhibitors?

Answer 6

Slow onset of action; slow offset (3-5 days after stopping)

It may take **weeks **for the stomach to recover normal acid production after discontinuation.

Question 7

What are some side effects of proton pump inhibitors?

Answer 7

Headache, N/V/D, pneumonia, rebound acid secretion if stopped abruptly, link to gastric cancers w/PPIs

Question 8

What drug interactions are associated with proton pump inhibitors?

Answer 8

d/t pH: Decreased absorption of some HIV medications and ketoconazole;
d/t CYP inhibition of conversion to active form: decreased effects of clopidogrel

decreased adverse AND beneficial effects of clopidogrel

Question 9

What is the activating pathway for acid secretion in parietal cells?

Answer 9

Histamine binds to H2 receptor on parietal cell

This binding triggers the proton pump to secrete H+ ions into the stomach lumen.