Proton pump inhibitors (PPIs): Nursing pharmacology

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Notes
PROTON PUMP INHIBITOR (PPIs) | ||
DRUG NAME | omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), esomeprazole (Nexium), dexlansoprazole (Dexilant) | |
CLASS | Proton pump inhibitor (PPIs) | |
MECHANISM OF ACTION | Inhibit H+/K+-ATPase on parietal cells in the stomach → decrease gastric acid secretion | |
INDICATIONS |
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ROUTE(S) OF ADMINISTRATION |
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SIDE EFFECTS |
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CONTRAINDICATIONS AND CAUTIONS |
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NURSING CONSIDERATIONS: PROTON PUMP INHIBITOR (PPIs) | ||
ASSESSMENT AND MONITORING | All proton pump inhibitors
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CLIENT EDUCATION | All proton pump inhibitors
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Transcript
Proton pump inhibitors, or PPIs for short, are medications used to treat conditions like peptic ulcers, gastroesophageal reflux disorder or GERD, and Zollinger-Ellison syndrome, which is caused by a gastrin-secreting tumor that leads to excess gastric acid secretion which then results in peptic ulcers.
Proton pump inhibitors are also included in the combination treatment against H. pylori, since they have a weak antibacterial effect.
Now, proton pump inhibitors usually end in “-prazole”, and include medications that are administered orally, like omeprazole, lansoprazole, dexlansoprazole, rabeprazole; as well as medications available intravenously, like pantoprazole and esomeprazole.
Once administered, proton pump inhibitors act on the parietal cells in the stomach by binding to and inhibiting the H+/K+-ATPase or proton pumps.
These pumps are involved in the secretion of gastric acid by exchanging potassium ions from the lumen with hydronium from the cells. As a result, proton pump inhibitors ultimately decrease gastric acid secretion.
Side effects of proton pump inhibitors are uncommon, but can include headaches, dizziness, fatigue, and blurred vision, as well as dry mouth, increased thirst, and hiccups.
In addition, some clients may experience gastrointestinal disturbances, such as increased or decreased appetite, nausea, abdominal pain, constipation, or diarrhea.
Also, prolonged acid suppression can decrease the absorption of iron, calcium, magnesium, and vitamin B12, or cobalamin.
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology: A patient-centered nursing process approach (8th edition)" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference (34th edition)" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination (8th edition)" Saunders (2019)
- "Goodman & Gilman's: The Pharmacological Basis of Therapeutics (13e)" McGraw-Hill Education (2018)
- "Pantoprazole" MedlinePlus (2021)