GI Pharmacology: Proton Pump Inhibitors (PPI)

In this portion of our gastrointestinal pharmacology, we’ll be going through proton pump inhibitors (PPI), and a bit about H2 blockers and antacids. But mostly, we’ll focus more on proton pump inhibitors.

What is PPI?

Proton pump inhibitors are the last, most effective GI medication to bring down the production of acid in the stomach. One of the well-known brands of PPIs is Protonix with a generic name of Pantoprazole. You can remember PPIs through its suffix, “-prazole.”

PPI: Mechanism of Action

The primary mechanism of action of proton pump inhibitors is to act on the gastric parietal cells to lower down the stomach’s acidity. Gastric parietal cells are found in the gastric lining and are responsible for secreting hydrochloric acid. Proton pump inhibitors inhibit hydrogen so that it won’t be released and trigger further gastric acid production.

PPI: Indications

Mostly, clients who have a history of gastritis, any type of peptic ulcer, and any type of acid reflux are the main recipient of proton pump inhibitors.

PPI in Hospitals

Here’s a trivia: 99% of clients admitted to hospitals will most likely be on a proton pump inhibitor medication.

Majority of clients in the hospital are given PPI to act as an ulcer prophylactic which serves as a preventive measure from ulcers. The other reasons why PPI are given are the following:

• When a client is on NPO
• When the client has been on bed rest
• When a client is not getting proper nutrition
• When a client is in so much pain

These factors contribute to the body creating the increased acid production. The increased gastrointestinal acidity will eat away the lining of the stomach and cause ulcer with bleeding, which could lead to a perforated stomach. By giving PPIs, we are inhibiting acid production the longest way possible.

PPI: Caution

With proton pump inhibitors, you have to make sure that it is not taken with food. Just like iron not given with dairy products or food, PPIs do not work well with food.

Proton pump inhibitors should be taken at least an hour or two before meals.

Quick Review

Before going on to H2 blockers and antacids, let’s summarize what we’ve learned, so far, about PPIs.

1. Proton pump inhibitors cease gastric secretions caused by the parietal cells inside the stomach.
2. Proton pump inhibitors are the best gastric medication when dealing with acid production because they are effective and lasts longer than the other gastric drugs given.
3. Proton pump inhibitors work best when it is given intravenously or orally; these are the just the two acceptable two routes.

H2 Blockers

Another gastric medication is H2 blockers. H2 blockers, which end in “-tidine,” primarily turns the acid volume down inside the stomach. A popular brand name for H2 blockers would be Pepcid that is shown in commercials as something to deal with heartburn.

Antacids

Among the types of gastric medications, antacids are considered as the weakest regarding its effects. Though antacids may work fast in relieving acidity, they’re not long-lasting, unlike PPIs.

That’s it for our proton pump inhibitor lecture and a bit of H2 blockers and antacids. Do drop by SimpleNursing’s website and YouTube channel for more informative lectures like this that will immensely help in passing your nursing exam.