PPIs and H2 Blockers on the NCLEX
Omeprazole, pantoprazole, famotidine: long-term risks, indications.
Acid-suppression therapy is everywhere. NCLEX tests indications and long-term PPI risks.
PPIs (-prazole)
Omeprazole, pantoprazole, esomeprazole, lansoprazole. Block H+/K+ ATPase. Most potent acid suppression. Long-term: B12 deficiency, hypomagnesemia, increased fracture risk, C. diff risk.
H2 blockers (-tidine)
Famotidine (Pepcid), nizatidine. Less potent than PPIs. Faster onset for symptom relief. Generally safer long-term.
When PPI vs H2
PPI for established GERD, PUD, prophylaxis on chronic NSAIDs. H2 for milder symptoms or PRN.
Taking
PPIs 30-60 min before first meal. H2 blockers any time, often at bedtime.
Frequently asked
Long-term PPI, when to stop?
Periodic reassessment. Many patients don't need ongoing therapy. Taper to prevent rebound.
Famotidine pulled?
Ranitidine pulled due to NDMA contamination. Famotidine remains available.
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