Proton Pump Inhibitor (PPI)
Lansoprazole; Omeprazole; Pantoprazole
- Prevention and treatment of peptic ulcer.
- Relieve symptoms of GORD.
- Treatment in H.Pylori
- Mode of Action:
- Inhibit the H+/K+-ase pump in the parietal cells. This reduces the amount of acid in the stomach. By working at this final stage it works better than H2-receptor antagonists by able to stop acid secretion completely.
- Adverse Reactions:
- Headache and gastric disturbances.
- Can increase risk of C.dif by increasing the pH in the body.
- Hypomagnesaemia (tetny & ventricular arrythmia)
- Can disguise the symptoms of gastric cancer.
- Also increase fracture risk in elderly so consider OP when prescribing.
- Can minimise the antiplatelet effect on clopidogrel (effect action of CYP450 enzymes).More of a problem with omoprazel so opt to use the others.
- Dependent on drug and what it's being used for. Can be IV or oral. Start low and titrate up
- Can be taken with or without food. Usually in the morning
- Explain reason for drug.
- Dose if H.pylori is 7 days vs proflaxis indefinitely.
- Look out for symptoms such as weight loss, swallowing difficulty ect (gastric cancer).
- Treatment of ulcer = endoscopy
- Prevention of symptoms = monitor symptoms
- Long term use = magnesium levels
NOTE - H.Pylori don't prescribe for 2 weeks before testing. False negative likely.