Week 11 - Proton Pump Inhibitors Flashcards
What is the MOA for the following drugs:
* esomeprazole
* omeprazole
* lansoprazole
* dexlansoprazole
* pantoprazole
Inhibit H+/K+ ATPase enzyme activity in gastric parietal cells
(decreases basal and stimulus induced acid secretion)
Proton pump inhibitors reduce gastric acid secretion by more than ________ %
90
True or false
PPIs exhibit anticholinergic and histamine type 2 receptor activity
False
All PPIs should be administered on a(n) _________ stomach
empty
* 30-60 minutes before meals
The PPIs are extensively metabolized by ________
CYP450 enzymes
The presence of __________ requires cautious use of PPIs
hepatic dysfunction
When clinically indicated, PPIs can be safely used for which patients?
Pregnant/breastfeeding
True or false
Some of the PPIs are safe for short term use in pediatric patients
True
* Esomeprazole
* omeprazole
* lansoprazole
What are some of the concerns with long term PPI use?
- nutrient deficiencies
- osteoporosis
- CKD
- GI infections
- Gastric cancers (maybe?)
PPIs may interact with drugs that require ________ for absorption
acidic gastric environment
Due to CYP450 actions Omeprazole has a significant interaction with which drug
Clopidogrel
* decreases active metabolite by 46%!
Short term use of PPIs may increase the risk for which kind of infection?
Pneumonia
In addition to PPI therapy, treatment for GERD should always include ________
lifestyle modifications
Some patients with Zollinger-Ellison syndrome have been treated with PPIs continuously for more than ________
5 years
For patients taking drugs metabolized by the CYP450 system, which PPI is the best choice?
Lansoprazole
* appears to have no clinically significant drug interactions with warfarin or other drugs metabolized by CYP450
