The document discusses proton pump inhibitors (PPIs), which are drugs that reduce gastric acid production by inhibiting proton pumps in the stomach. It outlines the five main PPI agents, how PPIs work by irreversibly binding to and inactivating the proton pump, and their indications and uses for conditions like peptic ulcers and gastroesophageal reflux disease. Triple therapy combining a PPI with antibiotics is also described as a treatment approach for Helicobacter pylori-associated peptic ulcers.

1. Welcome
Md. Ali Hayder
ID# 2015000300110
Batch: 25th
Sec: D
Southeast University (BD)

2. Assignment On:
Proton pump Inhibitor

3. Proton pump
O Integral membrane protein
O “Pumps” proton into the stomach
O By using ATP, an acidic hydrogen ion replace a non
acidic potassium ion.
(Ref: Katzung-12th/1084)

4. Proton pump Inhibitor
O Proton-pump inhibitors are a group of drugs whose
main action is a pronounced and long-lasting
reduction of gastric acid production.
O Inhibit the activity of proton pumps
(Ref: Robbins and Cotran -8th)

5. PPIs agent
O Five proton pump inhibitor are available for
clinical use:
1. Omeprazole
2. Esomeprazole
3. Pantoprazole
4. Lansoprazole
5. Rabeprazole
(Ref: Katzung-12th/1085)

6. Mechanism of action of PPIs
O PPIs are administered as inactive prodrugs.
O Converted into active form thiophilic sulfonamide
cation in the parietal cell.
O The sulfonamide reacts with the H+/K+ ATPase
(proton pump), form a covalent disulfide linkage.
O Irreversible inactivation of proton pump
O Counter-transport of H+/K+ ions via proton pump
is blocked
O No secretion of H+ by Parietal cell.
(Ref: Katzung-12th/1086-1087)

7. Mechanism of action of PPIs

8. Indication of PPIs
O Peptic ulcer disease (PUD)
H. pylori associated PUD.
NSAID associated PUD.
Perforation of bleeding PUD.
O Gastro-esophageal reflux disease
O Non ulcer dyspesia
O Stress-related mucosal bleeding
O Stress ulcer
(Ref: Katzung-12th/1087-1088)

9. Triple therapy
O Based upon a proton Pump inhibitor
O This is act against H. pylori associated PUD
O One proton pump inhibitor used with two
antibiotics (from amoxicillin, clarithromycin and
metronidazole) for 7 days.
O After completion of triple therapy, PPI should be
continued once daily for a total of 4-6 weeks.
(Ref: Davidson’s-medicine-20th/887,888)

10. Adverse effects of PPIs
O General: PPIs are safe drug but 1-5% cases the
following adverse effect are reported-
Diarrhea
Headache
Abdominal pain
Safety during pregnancy is not established
O Subnormal Vitamin B12 level ( prolonged use)
O Respiratory & enteric infection
(Ref: Katzung-12th/1088-1089)

11. Thanks