🗯GASTROINTESTINAL SYSTEM
◼️Proton pump inhibitors (PPIs)
◾Example:
▪️(Omeprazole, lansoprazole, esomeprazole, pantoprazole)
◾Mechanism of action:
▪️ Inhibit H+/K+ ATPase on luminal surface of gastric parietal cells and thereby reduce gastric acid secretion.
◾Indication:
▪️Gastric/duodenal ulceration
▪️ As part of triple therapy for eradication of Helicobacter pylori
▪️Gastro-oesophageal reflux disease
▪️Acid-related dyspepsia
▪️Prevention and treatment of NSAID-associated ulcers
▪️Hyper-secretory conditions, including Zollinger-Ellison syndrome
◾CAUTIONS AND CONTRA-INDICATIONS
▪️ Hypersensitivity
▪️If red flag features of malignancy need to investigate prior to initiating treatment
◾Side effects:
▪️GI disturbance (e.g. abdominal pain, nausea, vomiting, diarrhoea)
▪️Increased risk of gastric infections due to hypochlorhydria
◾Metabolism and half-life:
▪️ Extensively metabolised by liver and excreted by both renaland biliary routes. ty, varies from 40 min to 2 h.
◾Montoring:
▪️No specific drug monitoring required.
◾Drug interaction:
▪️PPls are inducers of Cytochrome P450 with some variation in potency between theindividual drugs and, therefore, may enhance effects of drugs metabolised by the liver(e.g. phenytoin, carbamazepine, warfarin)
◾Important points:
▪️PPls reduce acid secretion by >90% and are therefore more effective at healing peptic ulcersSiden H₂ receptor antagonists (which reduce acid secretion by 50-60%)
▪️IV PPls can be used in the managementof acute upper GI bleeds under specialist supervision
#طوفان_الأقصى 🇵🇸#غزة_تنتصر 🇵🇸
د. ص/شذى القباطي