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PPIs

QuestionAnswer
Suppress gastric acid secretions by inhibition of the H+/K+/ATPase enzyme system at the secretory surface of the parietal cell itself to block the final step in H+ secretion.
ADRs: PPIs nutritional deficiencies, Fe, VB12, Ca+ need acid environment for absorption
Long-term therapy PPIs may be at risk for osteoporosis, microbial pathogens such as C.diff, salmonella, camphylobacter pneumonia
Drug interactions with PPIs: avoid concurrent use of Plavix with PPIs; monitor Coumadin and INR b/c absorption may be decreased d/t decreased acidicness
PPIs in tx of duodenal and gastric ulcers: Prevacid, Prilosec, Nexium, Aciphex daily for 12 weeks any PPI for tx combination for H.pylori
PPIs in tx of GERD: any PPI initially for 4-8 weeks daily; if no relief may try bid for 8 weeks
PPIs may mask the sx of gastric cancers and alarm symptoms are: dysphagia, painful swallowing, noncardiac CP, weight loss, hematemesis, choking
PPIs in tx of Zollinger-Ellison Syndrome: any PPI but may need higher dosing than does GERD or PUD tx sometimes continues for more than 5 years
Best choice for patients taking other drugs metabolized by the CYP450 Prevacid
Created by: heatherbrown2020
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