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Related Concept Videos

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors01:13

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors

Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
Peptic Ulcer Disease IV: Management01:26

Peptic Ulcer Disease IV: Management

Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
Drug toxicity: Drug–Drug Interaction01:30

Drug toxicity: Drug–Drug Interaction

Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids01:31

Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids

In the complex environment of the gastric lumen, excessive acid secretion can lead to the formation or worsening of ulcers within the delicate mucosal layer. Antacids, such as sodium bicarbonate and calcium carbonate, provide relief by neutralizing this acid, transforming it into harmless salt and water. This neutralization process raises the gastric pH from a highly acidic level of 1 to a more basic 3-4, reducing the acidity within the stomach.
However, this neutralization reaction between...
Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists01:28

Acid Suppressive Drugs for Peptic Ulcer Disease: Histamine H2-Receptor Antagonists

Histamine H2 receptors, which are intricately located on the basolateral membrane of parietal cells, play a crucial role in modulating gastric acid secretion. When released from enterochromaffin-like cells, histamine engages H2 receptors, initiating the cyclic AMP (cAMP) pathway. In this pathway, adenylyl cyclase converts ATP into cAMP, elevating intracellular cAMP levels. The activation of protein kinase A follows, stimulating the proton pump. This stimulation prompts the secretion of hydrogen...
Peptic Ulcer Disease I: Introduction01:30

Peptic Ulcer Disease I: Introduction

Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...

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Related Experiment Video

Updated: Jun 20, 2026

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
05:23

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance

Published on: March 7, 2025

Inappropriate use of proton pump inhibitors.

D Molloy1, A Molloy, C O'Loughlin

  • 1Department of Pharmacology and Therapeutics, St James's Hospital, Dublin 8, Ireland. debmolloy@eircom.net

Irish Journal of Medical Science
|September 19, 2009
PubMed
Summary

Proton pump inhibitor (PPI) use in Irish hospitals is common, but often inappropriate. Most PPI prescriptions were not aligned with guidelines, and many were for unapproved uses, indicating a need for better prescribing practices.

Related Experiment Videos

Last Updated: Jun 20, 2026

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
05:23

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance

Published on: March 7, 2025

Area of Science:

  • Gastroenterology
  • Clinical Pharmacy
  • Internal Medicine

Background:

  • Proton pump inhibitors (PPIs) represent a significant pharmaceutical expenditure.
  • Widespread use of PPIs necessitates evaluation of prescribing patterns.

Purpose of the Study:

  • To assess the prevalence and appropriateness of PPI utilization in acute medical settings in Ireland.
  • To identify indications for PPI prescribing and adherence to clinical guidelines.

Main Methods:

  • A cross-sectional study design was employed.
  • Review of 55 medical charts over a one-month period.
  • Data collection included PPI prescription details and patient admission information.

Main Results:

  • Proton pump inhibitors were prescribed to 33 patients, with 26 initiated prior to hospital admission.
  • Prescribing practices were concordant with established guidelines in only 30% of cases.
  • A significant proportion, two-thirds, of PPI use was off-label or unlicensed.

Conclusions:

  • Current PPI prescribing in Irish acute medical wards frequently deviates from evidence-based recommendations.
  • A substantial amount of PPI use is for unlicensed indications, highlighting potential for medication review and optimization.
  • There is a clear need for improved stewardship of PPIs to ensure appropriate and cost-effective use.