PROTON PUMP INHIBITORS - - - What is it?? What are they?? Do we all have them??

Nurses General Nursing

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Another class I slept thru !!

I didn't know I had a proton pump ....

Any of you got the pp knowledge to share ??

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It is a classification of some new GI drugs. It is the next level after prevacid, etc. And more expensive. :)

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Specializes in tele, stepdown/PCU, med/surg.

Prevacid, Protonix, Prilosec are all proton pump inhibitors. They are medications that reduce HCL production and are noted for their ability to heal gastric/esophageal erosions. These drugs produce long-lasting relief from esophageal reflux/ulcer disease.

These drugs have surpassed in efficacy the H2 receptor antagonist drugs such as zantac, pepcid etc...

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Specializes in NICU.

They get the name because they refer to a hydrogen ion as a proton.

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Thanks ................

Allnurses Nurses are SMART ! ! !!

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One other thing...

Up to 6% of patients taking PPI's will get headache. A limiting factor for migrainers. (like me.)

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One other thing...

Up to 6% of patients taking PPI's will get headache. A limiting factor for migrainers. (like me.)

I think my migraines are worse when I have acid reflux than when I take my nexium, however. :) No can get off PPI's ever...thanks to biology and depakote (which I haven't taken since 2001!)... Lots of the headache meds cause very bad reflux, so it seems like everyone is on some type of PPI or H2 antagonist these days! If the nexium ever quits working for me, I'm in trouble!

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I think my migraines are worse when I have acid reflux than when I take my nexium, however. :) No can get off PPI's ever...thanks to biology and depakote (which I haven't taken since 2001!)... Lots of the headache meds cause very bad reflux, so it seems like everyone is on some type of PPI or H2 antagonist these days! If the nexium ever quits working for me, I'm in trouble!

There probably is a relationship between migraine drugs and reflux. Serotonin plays some role in lower esophageal sphinctor muscle tone. You'll recall that all the old "dirty" ergotamine-type drugs would make people hurl... among other things.

On balance nexium/prilosec/etc. are really good, safe drugs. I'm just p----d that they took Vioxx off the market and told folks with osteoarthritis to just take ibuprophen with a nexium. I take the NSAID... I get reflux. I take the nexium, I get headache (along with 6% of all users). So now I'll end up having surgery for the pain. It's stupid.

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There probably is a relationship between migraine drugs and reflux. Serotonin plays some role in lower esophageal sphinctor muscle tone. You'll recall that all the old "dirty" ergotamine-type drugs would make people hurl... among other things.

On balance nexium/prilosec/etc. are really good, safe drugs. I'm just p----d that they took Vioxx off the market and told folks with osteoarthritis to just take ibuprophen with a nexium. I take the NSAID... I get reflux. I take the nexium, I get headache (along with 6% of all users). So now I'll end up having surgery for the pain. It's stupid.

Arg...that stinks. Hugz!!! I still use DHE...the good ole ergot derivative. It makes me sick like no other! The last time I used it was mid-shift working in the ER. I had taken 8mg of zofran about 45 minutes before I got the shot. I can't take reglan or compazine due to some pretty intense reactions, so Zofran is my one and only. Well, about 10 minutes after my friend gave me the DHE injection, I had to excuse my self from interviewing a patient with a nurse...ran back to the patient bathroom (ew) and threw up about 6 times. It was awful, but this seems to happen to me every time I use DHE. My neuro told me to cut the dose down to 1/2mg because when I have a level 10 mig and then take the whole mg and throw it up, it doesn't do much good! LOL

I used to take Vioxx for orthopedic stuff. My current ortho gave me celebrex, but it didn't help, so I stopped taking it. Right now I take a combo of aspirin and naproxen daily for post-op prevention of clots and lessening inflammation. For me, though, I'm just trying to put off joint replacement. Wouldn't have ever progressed so quickly through Avascular Necrosis had it not been for headache drugs... :(

I did take indomethacin for awhile, but it really felt like it was eating a hole through my gut lining. I quit taking it when it wasn't helping at all!

One thing I've always detested throughout my headache/migraine treatment was having to take one drug to treat the side effects of another. The only reason I have a whole supply of zofran is because lithium and zonegran made me throw up every day. I also take concerta related to memory loss from topamax, which I never recovered from...even though I've been off the drug for a long time. That kind of thing is upsetting. They don't tell ya that when you sign on to take it. :(

Hugz,

carrie :) :Melody:

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Wow. I admire you for even trying to work with a migraine. I fold like a taco. Fortunately in the job I'm in right now (research) no one is hurt if I go home.

Have you ever tried any of the triptans? Imitrex, Maxalt, Amerge etc.? They aren't perfect but they give me relief from about 90% of my headaches. Sometimes the pain is just too bad, or I wait too long to take the drug.

If you haven't given them a try, you should. They work on a specific type of serotonin receptor, one that is present on meningeal blood vessels (I think) but not highly expressed in the gut, hense way fewer GI symptoms. They are pretty safe, but there is some caution if you have vascular disease.

Do ask your doctor about them. Every migrainer should be offered these drugs if there is no contraindication.

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Wow. I admire you for even trying to work with a migraine. I fold like a taco. Fortunately in the job I'm in right now (research) no one is hurt if I go home.

Have you ever tried any of the triptans? Imitrex, Maxalt, Amerge etc.? They aren't perfect but they give me relief from about 90% of my headaches. Sometimes the pain is just too bad, or I wait too long to take the drug.

If you haven't given them a try, you should. They work on a specific type of serotonin receptor, one that is present on meningeal blood vessels (I think) but not highly expressed in the gut, hense way fewer GI symptoms. They are pretty safe, but there is some caution if you have vascular disease.

Do ask your doctor about them. Every migrainer should be offered these drugs if there is no contraindication.

:) 5-HT1, I believe, right? I can't tolerate Imitrex because I have a big problem with tachycardia - the 'trex makes my heart beat wayyyyy faster than it should. I wasn't a fan of that!

I use zomig NS and amerge...but for 2 different things. Zomig is so short-acting, but also works very quickly (esp in nasal spray), so I use it for cluster headaches when I'm away from my oxygen tanks. Amerge takes a long time to work, but it lasts much longer, and it'll knock my daily migraine down to a level 3-5 instead of 8-10, so that I function much better! Frova has the longest half-life, but it doesn't do anything for me, unfortunately!

I see a neurologist at a top headache center, and in fact I used to work as a research assistant there for a little while. I went on to develop a rather lengthy project on improving the quality of migraine and headache education for nurses -- now if I could *just* use that to find something that helped ME, I would be golden!!! haha

Something like 98% of migraineurs can find an effective preventative...and I've fallen in the 2% group for 4.5 years now...except for Kudzu. That would have been great if I hadn't hemorrhaged so soon after starting it! :uhoh3:

Therre are days when I get tired of being the guinea pig, but such is life, eh?

hugz,

carrie :Melody:

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I figured you'd be on top of it.

I had TMJ surgery to rebuild a joint that was pretty much eroded away. I had the surgery because I couldn't eat, had little to do with headache. BUT, my headaches seem milder since the surgery.

None of the prophylactic things work for me, mostly due to side-effects... (I mean think about it, some of those things are beta blockers, some are anticonvulsants... Of course they will have huge side-effect profiles!)

On the otherhand, there is a lot of research going on in the field of headache and pain in general so take heart. The triptans were a big breakthrough in our understanding of migraine. Maybe another advance will come along soon.

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