Proton Pump Inhibitors (PPIs)

Key Points

• Memory aid: Remember the "P's" of PPIs.
• Suffix: PPIs can be identified by the suffix -prazole.
  • Examples:
    • Esomeprazole (Nexium)
    • Omeprazole (Prilosec)
    • Pantoprazole (Protonix)

Functions and Uses

1. Pause Acid Production

   • Mechanism: Inhibit the proton pump in the stomach to stop excess acid production.

2. Prevent Ulcers

   • Uses: Prescribed to prevent and treat duodenal/gastric ulcers.
   • Common in hospitals to manage stress-induced ulcers.
   • Patient Education: Explain why PPIs are ordered in hospitals even if not taken routinely.

3. H. pylori Treatment

   • PPIs can treat H. pylori, a common bacterial infection in the stomach.
   • Also helpful for managing GERD by reducing stomach acid.

Side Effects and Risks

• Porous and Spongy Bones

  • Long-term use can result in bone fractures or osteoporosis due to decreased calcium absorption.

• Potential Infections

  • Reduced stomach acid increases susceptibility to infections like C. diff.
  • Other side effects: Nausea, diarrhea, upset stomach.

Usage Guidelines

• Prior to Meals

  • Take PPIs 30 minutes before the first meal of the day.
  • Calcium and Vitamin D supplements are recommended to prevent osteoporosis and bone fractures.

• Prevent Taking Pain Meds

  • Avoid medications that irritate the stomach such as aspirin and NSAIDs (e.g., Advil).

Summary of the P's of PPIs

• Prazole: Suffix identifying PPIs.
• Pause: Inhibit acid production.
• Prevent Ulcers: Treat and prevent duodenal/gastric ulcers.
• Pylori: Treat bacterial infection H. pylori.
• Porous Bones: Long-term use risks include fractures or osteoporosis.
• Potential Infection: Risk of GI infections like C. diff.
• Prior to Meals: Take 30 minutes before the first meal of the day.
• Prevent Pain Meds: Avoid aspirin and NSAIDs.

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