Gastritis, PUD, and GERD: H2 Antagonists and Proton Pump Inhibitors (Nursing)

00:01 Second, on our list, we have H2-receptor antagonists.

00:04 Now, imagine these as a dam blocking the flow of acid production.

00:08 They work by blocking histamine receptors on the parietal cells, that ends up reducing acid secretion. So, famotidine is a common example of an H2-receptor antagonist.

00:20 So, as expected, famotidine works by blocking the H2 receptors on gastric parietal cells, this is what helps to suppress the secretion of gastric acid.

00:30 Now, some of the conditions that famotidine can be used to treat include short-term gastric and duodenal ulcers, prophylaxis of recurrent duodenal ulcers, and gastroesophageal reflux disease or GERD.

00:42 Famotidine can be administered orally, intramuscularly, or intravenously, depending on the needs of the patient.

00:49 While the drug is generally well-tolerated, some patients may experience side effects such as headache, dizziness, constipation, or diarrhea.

00:59 Now remember, the elderly are particularly sensitive to these side effects. Additionally, famotidine may interact with other drugs that depend on gastric pH for absorption, such as ketoconazole. So, as an important note, famotidine is metabolized in the liver and mainly excreted by the kidneys.

01:15 This means that in patients with moderate to severe kidney problems, the elimination of famotidine may be decreased, which may lead to an increase in the risk of side effects.

01:25 So, to avoid this, it's important to reduce the dosage of famotidine in patients with moderate to severe renal impairment or just avoid it altogether.

01:34 Another way we can protect the stomach are proton pump inhibitors, now these are like a master switch. They can shut off acid production at its source.

02:24 PPIs, such as omeprazole and pantoprazole, inhibit the enzyme responsible for acid secretion in parietal cells. First, let's talk about omeprazole.

02:29 It's a proton pump inhibitor that irreversibly blocks the H+/K+-ATPase enzyme system, also known as the proton pump.

02:34 Now, this mechanism of action reduces gastric acid secretion, so it provides relief from symptoms and promotes healing. Omeprazole is a helpful medication used to treat conditions like active duodenal ulcers, erosive esophagitis, and gastroesophageal reflux disease. Plus, it can be used as a preventive measure to protect against peptic ulcer disease. Now, when it comes to administration, omeprazole is typically taken orally once a day before a meal, although some patients may require twice a daily dosing. Side effects of omeprazole can include headache, abdominal pain, nausea, diarrhea, and constipation.

03:05 So, it's important to note that omeprazole may interfere with the absorption of drugs that require an acidic gastric pH for optimal bioavailability, such as digoxin, ketoconazole, and iron salts. So, omeprazole is available in both prescription and over-the-counter formulations. Now let's discuss pantoprazole.

03:17 Like omeprazole, pantoprazole is a proton pump inhibitor with the same mechanism of action, same indications, same side effects, and drug interactions. However, there are a few differences to consider.

03:25 Pantoprazole has a longer half-life, so this could allow for maybe only once-daily dosing.

03:29 This can be really helpful for patients who struggle with medication adherence.

03:32 Additionally, Pantoprazole is available as an injectable formulation for short-term treatment of GERD, providing an alternative option for patients who cannot take oral medications or require rapid relief. And always remember that the word “-prazole” equals proton pump inhibitors drugs, and they reduce acid secretion by inhibiting the proton pump in the parietal cells.