Pharmacology
Sample Question

Proton pump inhibitors (PPIs) (eg, pantoprazole, omeprazole) block proton pumps located in the parietal cells of the stomach, which reduces gastric acid secretion. This results in decreased acid accumulation and increased gastric pH, which prevent gastroesophageal irritation and ulcers. PPIs are commonly prescribed to clients with gastroesophageal reflux disease,) peptic ulcer disease, Helicobacter pylori infection, and other hypersecretory conditions.

Certain medications are contraindicated in clients receiving PPIs, so the nurse should monitor for medication interactions when reviewing the client's prescriptions. PPIs inhibit the enzyme that metabolizes warfarin. When these medications are taken concurrently, warfarin levels increase, thereby raising the client's INR and risk for bleeding (Option 2).

(Option 2) Clients receiving PPIs should not take NSAIDs (eg, ibuprofen, naproxen) due to the increased risk for gastrointestinal bleeding. Acetaminophen is a safe alternative for pain relief for these clients.

(Option 3) Albuterol is a short-acting beta-2 agonists that causes bronchodilation and improves hypoxia in clients with asthma and other respiratory conditions. Albuterol can be safely used with PPIs.

(Option 4) Long-term therapy with PPIs may decrease calcium absorption and lead to an increased risk for osteoporosis and bone fractures. Calcium supplementation with calcium carbonate is safe for clients receiving PPIs.

Educational objective:
Proton pump inhibitors (PPIs) (eg, pantoprazole) block proton pumps in the stomach, which reduces gastric acid secretion. Certain medications are contraindicated in clients receiving PPIs. Because PPIs inhibit the metabolism of warfarin, the risk for bleeding increases when these medications are taken concurrently.