Proton Pump Inhibitor Study Guide PDF

STUDY GUIDE - PHARMACOLOGY Proton Pump Inhibitor MECHANISM OF ACTION: PPIs block the hydrogen potassium aTPase pump also known as proton pump on the gastric parietal cell responsible for secreting hydrogen ions. This will bind with chloride to fo...

STUDY GUIDE - PHARMACOLOGY Proton Pump Inhibitor MECHANISM OF ACTION: PPIs block the hydrogen potassium aTPase pump also known as proton pump on the gastric parietal cell responsible for secreting hydrogen ions. This will bind with chloride to form hydrochloric acid or stomach acid. Blocking this pump reduces the acidity of stomach contents. Remember the suffix, "-prazole" -- “Turn off the pump” e.g. Omeprazole, Pantoprazole, Lansoprazole THERAPEUTIC USE GERD - acidic gastric contents lead Erosive esophagitis – decrease inflammation of esophagus lining caused by reflux. Peptic ulcer disease Treats H. pylori infection by promoting the antibiotic effect as it subsides the production of gastric acid. Prevention for stress ulcers due to intensive surgery. ADVERSE EFFECT: PPI change stomach PH leading to microorganisms to grow C.diff risk in long-term therapy. Pneumonia - when small amount of acid containing bacteria can be aspirated into the lungs Rebound acid hypersecretion where gastric cell produces stronger acid than before Tapering is recommended by gradually reducing the dosage of a medication to reduce or discontinue it. Malabsorption of minerals and vitamins leading to poor calcium absorption For more than 2 years - reduced vitamin b12 causing pernicious anemia Low magnesium absorption -hypomagnesemia Osteoporosis – PPI causes decreased calcium absorption thus, long-term use may cause bone fragility leading high risk of fracture CLIENT TEACHING Take lowest dose + shortest amount of time -- lesser adverse effects Discontinue if no clear indication Report for any s/s of diarrhea, cramps immediate fever – possible C.diff Adequate intake of Vitamin D and Calcium Take it 30 to 60 before meal will allow the drug to attach to proton pump cells Orals suspensions are available Avoid NSAIDS and Aspirin when taking PPI Take with Calcium and Vitamin D supplements to prevent osteoporosis. For ER tablet - do not chew or crush Client should report diarrhea when in prolonged use. DRUG INTERACTION ANTIPLATELET SUCH AS CLOPIDOGREL -- enzymes may interact with PPI to activate HIV medications needs stomach acid and PPIs may decrease their effectiveness Inhibits enzyme that metabolizes warfarin.