PPI's

Question 1

Examples

Answer 1

• Omeprazole, lanzoprazole

Question 2

Mechanism

Answer 2

• Irreversible inhibition (H+K+ATpase) proton pump in stomach -> Decreases acid secretion

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Question 3

Indications

Answer 3

• Peptic ulcers
• Helicobacter pylori eradicaton (omeprazole, clarithromycin, metronidazole/amoxicillin)
• GORD

Question 4

Side effects

Answer 4

Common: GI upset, headache

Important: Rebound acid hypersecretion - increase HCl after, PPI, Hepatitis, Interstitial nephritis, Blood disorders (leucopenia, leucocytosis, pancytopenia, thrombocytopenia) Increased risk of Clostridium difficile infection, hypomagnesaemia

Question 5

Contraindications

Answer 5

• Masks gastric cancer
• Pregnancy/breast-feeding

Question 6

Interaction

Answer 6

• Warfarin (Omeprazole and esomeprazole increase anticoagulant effect)
• Clopidogrel (Omeprazole and esomeprazole may reduce antiplatelet effect)