Proton Pump Inhibitors

Question 1

What are some examples of PPIs and what do they do

Answer 1

Omeprazole, lanzoprazole, pantoprazole

- REDUCE GASTRIC ACID SECRETION

Question 2

What are the indications for use of PPIs

Answer 2

• Peptic ulcer disease (gastric/ duodenal)
• NSAID-ass ulcers
• GORD/ oesophagitis/ dyspepsia
• Eradications H. pylori (in combo w/ Abx)

Question 3

What is the mechanism of action of PPIs

Answer 3

• Inhibit H+/K+ ATPase proton pump –> H+ needed for HCl

- Irreversible + effective after 2hrs

Question 4

What are the side effects of PPIs

Answer 4

• GI disturbances (N, V, D)
• Headache
• if prolonged treatment may –> hypomagnesaemia

Question 5

What to be careful of

Answer 5

• May disguise symptoms of gastric cancer

- can ^ risk fracture in elderly - osteosporosis warning

Question 6

What are the interactions and contraindications

Answer 6

• CYP450 inhibitor (can reduce anti-platelet effect of clopidogrel - activated by CYP450)