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Proton pump inhibitors.

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VOL: 102, ISSUE: 11, PAGE NO: 31

Generic and proprietary names

- Nexium: esomeprazole.

- Zoton: lansoprazole.

- Losec: omeprazole.

- Protium: pantoprazole.

- Pariet: rabeprazole.

- Combined preparations that include antibacterial medication are also available.


- The proton pump inhibitors inhibit the production of gastric acid by blocking the hydrogen-potassium adenosine triphosphate enzyme system of the gastric parietal cells.


- Gastrointestinal system: proton pump inhibitors.


- Liver disease.

- Pregnancy.

- Breastfeeding.

- Symptoms of gastric cancer.


- Lansoprazole, omeprazole, pantoprazole and rabeprazole are licensed for the short-term treatment of benign duodenal and gastric ulcers.

- Proton pump inhibitors are used in conjunction with antibiotics for the eradication of Helicobacter pylori.

- Esomeprazole, lansoprazole and omeprazole are licensed for NSAID-associated peptic ulcers.

- A short course of proton pump inhibitors is the initial treatment in oesophageal reflux.

- Omeprazole is effective in the treatment of Zollinger-Ellison syndrome and acid reduction during general anaesthesia.

Common side-effects

- Gastrointestinal upset.

- Headache.

- Dizziness.

Less common side-effects

- Dry mouth.

- Insomnia.

- Drowsiness, malaise.

- Blurred vision.

- Rashes, itching.


- The effects of phenytoin and warfarin are increased by some proton pump inhibitors.

- The absorption of the antifungal drugs ketoconazole and itraconazole is reduced by proton pump inhibitors.

- The breakdown of diazepam in the body may be blocked by some proton pump inhibitors so that it has an increased effect.


- Tablet, capsule, powder for suspension or injection.

Nursing considerations

- In combination with antibiotics, proton pump inhibitors are used to eradicate H. pylori infection, one of the main causes of recurring stomach ulcers.

- The differences between proton pump inhibitors in clinical efficacy and safety are considered to be minimal.

- Patients who require long-term symptom management should reduce their use of prescribed medication stepwise: using the lowest effective dose, then as required before returning to self-treatment with antacid and/or alginate therapy.

Patient teaching

- Advise patients to avoid precipitants they associate with their dyspepsia such as smoking, alcohol, coffee or fatty foods.

- Overweight patients should be advised that weight reduction will help their condition.

- Other actions such as raising the head of the bed or not eating a main meal too close to going to bed may help some people.

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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