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Proton Pump Inhibitors (PPIs)

What are proton pump inhibitors?

Proton Pump Inhibitors (PPIs) are a class of drugs that are used in the treatment of heartburn, gastric ulcers and various acid related disorders. They work by decreasing gastric acid production.

List of PPI drugs:

Examples of available PPI medications include:

  1. Dexlansoprazole(Dexilant)
  2. Lansoprazole (Prevacid)
  3. Esomeprazole(Nexium)
  4. Omeprazole(Prilosec)
  5. Omeprazole and Sodium Bicarbonate (Zegerid)
  6. Pantoprazole(Protonix)
  7. Rabeprazole(Aciphex)

*Note: All the generic names of this drug class end in the suffix “prazole”.

How do they work?

In the stomach there is an enzyme system that regulates and causes acid secretion by the cells lining the stomach, this system is also known as (proton pump). This system will facilitate acid secretion by transporting hydrogen ions into the stomach.

Proton pump inhibitors act by reducing gastric acid production by blocking hydrogen- potassium and adenosine triphosphate enzyme system (the proton pump) of the parietal cells.

Uses of PPI medications

Generally, proton pump inhibitors are used in the prevention and treatment of various gastric disorders, including:

►Gastroesophageal reflux disease (GERD)

►Dyspepsia (indigestion)

►Zollinger-Ellison syndrome

►Duodenal ulcers

►NSAIDs associated gastric ulcers

►Helicobacter pylori infection

PPIs’ Side effects

These drugs may cause some unwanted effects. Common side effects caused by proton pump inhibitors include:

- Abdominal pain

- Diarrhea

- Constipation

- Vomiting

- Nausea

- Dry mouth

- Headache

- Hyperglycemia

Uncommon and rare side effects may include:

- Hallucination

- Confusion

- Vertigo

- Gynecomastia (enlargement of the breast tissue in men)

- Liver disorders

Who can't use PPIs?

Patients with the following conditions should consult a doctor before using any of these drugs:

  • Allergy to any medicines or other substances
  • Liver disease
  • Stomach infection

Interactions with drugs

PPI drugs can form drug-drug interactions with the following medications:

- Antifungals

- Clopidogrel

- Diazepam

- Digoxin

- Hypomagnesemia-causing drugs

- Iron supplements

- Phenytoin

- Sucralfate

- Tacrolimus

- Theophylline

References

1. Kizior, R.J. and Hodgson, B.B. (2018). Saunders nursing drug handbook 2019. Philadelphia: Saunders.

2. British Medical Association (2015). British Medical Association new guide to medicine & drugs. London: Dorling Kindersley

3. Joint formulary committee, BNF 80 (The British National Formulary), 80th revised edition, Pharmaceutical Press, London, United Kingdom, [2020]

4. Winter, H., Moore, S.W., Boesen, K. and Boesen, C. (2017). Complete guide to prescription & nonprescription drugs, 2018-2019. New York: Tarcherperigee, An Imprint Of Penguin Random House Llc.

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