Paper II
2015 February (2010 Scheme) · 40 marks · 120 min

Question

Proton pump inhibitors

Q33 marksShort Notes

Answer

Examples: Omeprazole, Pantoprazole, Lansoprazole, Rabeprazole, Esomeprazole

Mechanism of action

  • Prodrugs activated in the acidic parietal cell canaliculus
  • Irreversibly inhibit the H⁺/K⁺-ATPase (proton pump), the final common step of gastric acid secretion, producing profound and long-lasting suppression of acid output

Uses

  • Peptic ulcer disease, GERD, Zollinger-Ellison syndrome
  • H. pylori eradication regimens
  • NSAID-induced ulcer prophylaxis

Adverse effects

  • Headache, GI upset
  • Long-term: fracture risk, vitamin B12 deficiency, hypomagnesaemia, increased risk of C. difficile infection and pneumonia

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