Site icon almostadoctor

Proton Pump Inhibitors – PPIs

Introduction

Proton pump inhibitors (PPIs) are a commonly prescribed medication typically for symptoms of gastro-oesophageal reflux, peptic ulcer disease, and as gastroprotection where conditions or other prescribed drugs increase the risk of gastritis – such as when using steroids or NSAIDs.

Adverse effects are generally unusual, but it should be noted there is an increased risk of osteoporosis associated with long-term use, and that PPIs are known to alter gut flora – although the clinical result of this is unclear (and probably not hugely significant).

Generally you should use the lowest dose for the shortest period of time. Latest guidelines suggest a PRN (As required) approach to usage.

I sometimes use the analogy of “sun burn” when describing inflammation in the stomach caused by dyspepsia or reflux. This helps to explain about intermittent usage of PPIs, and why it seems that symptoms may not be immediately resolved. For example – like sunburn, gastric inflammation may take days to resolve, and may continue indefinitely if the cause isn’t removed (e.g. lifestyle factors +/- PPI use). BY removing factors that cause the inflammation you then allow the mucosa time to recover. – Dr Tom Leach

Esomeprazole box. PPIs are widely available and some smaller doses may be available without prescription in some jurisdictions.

Mechanism of action

Proton pump inhibitors act by irreversibly inhibiting H+/K+-ATPase in gastric parietal cells.

Adverse effects

Indications

Examples

Generally PPIs have similar therapeutic effects, and mainly differ in their drug interactions (particularly omeprazole appears more likely to interact).

Pantoprazole is traditionally considered the “strongest” PPI.

Cautions

Interactions

References

Read more about our sources

Related Articles

Exit mobile version