Proton pump inhibitors Flashcards
Name examples of proton pump inhibitors.
esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole.
What are the indications for PPIs?
benign gastric ulcers, gastric ulcers (pantoprazole), duodenal ulcers, NSAID-associated gastric ulcer, NSAID-associated duodenal ulcer (omeprazole), NSAID-associated gastroduodenal erosions (omeprazole), prophylaxis of NSAID-associated gastric/duodenal ulcer (esomeprazole, lansoprazole), prophylaxis of NSAID-associated gastric/duodenal ulcer in patients with previous history of ulcer (omeprazole, pantoprazole), GORD, Zollinger-Ellison syndrome, severe peptic ulcer bleeding following endoscopic treatment (esomeprazole, omeprazole), H. pylori eradication in combination with antibiotics, severe oesophagitis (lansoprazole, rabeprazole), acid-related dyspepsia (lansoprazole, omeprazole), prevention of relapse in gastric/duodenal ulcer (omeprazole), acid reflux disease, long-term management (omeprazole), treatment and prevention of benign gastric/duodenal/NSAID-associated ulcers (omeprazole), treatment and prevention of GORD (omeprazole)
State the mechanism of action of PPIs.
They suppress gastric acid secretion by inhibiting the hydrogen-potassium adenosine triphosphate (proton pump) enzyme system (specifically the enzyme hydrogen/potassium ATPase) on the apical membrane of gastric parietal cells, blocking final production of HCL and lowering stomach acid levels.
What are the very common/common unwanted side effects of PPIs?
abdominal pain, agitation, asthenia, back pain, benign fundic gland polyps, constipation, cough, diarrhoea, dizziness, dry mouth, fatigue, flatulence, gastro-intestinal disturbances, headache, hyperlipidaemia, impotence, increase in liver enzyme levels, influenza-like syndrome, insomnia, itching, nausea, rash, rhinitis, urticuria, vomiting, weight changes.
What are the monitoring requirements of PPIs?
Measure serum-magnesium concentrations before and during long-term treatment with a PPI, especially when used with drugs that cause hypomagnesaemia or with digoxin.
What is the patient/carer advice for lansoprazole?
advise patients on administration of gastro-resistant capsules, tablets, granules, and orodispersible tablets.
