Proton Pump Inhibitors

Question 1

What are the indications of PPIs? (7)

Answer 1

1. Gastric and duodenal ulcers (short-term)
2. H.pylori eradication therapy in combination with antibiotics
3. High-dose IV PPIs for GI bleed to prevent rebleed
4. Treatment of dyspepsia and GERD
5. Gastroprotection in patients taking NSAIDs
6. Patients with CF to decrease degradation of pancreatic enzyme supplements
7. Zollinger-Ellison syndrome to control excess gastric acid secretion (high doses often required)

Question 2

What is the mechanism of action of PPIs?

Answer 2

Block H+/K+ pump of gastric parietal cells

Question 3

What are the adverse effects associated with PPIs? (5)

Answer 3

1. Hyponatremia
2. Hypomagnesemia
3. Osteoporosis and increased risk of fracture
4. Microscopic colitis
5. Increased risk of C.diff and other GI infections