Which of the following drugs is a proton pump inhibitor?

Appeared in: AIIMS Patna NO - 2020

Explanation

Pantoprazole is a proton pump inhibitor (PPI), a class of drugs that potently suppresses gastric acid secretion.
Its mechanism of action involves irreversibly binding to and inhibiting the H+/K+ ATPase enzyme system (the 'proton pump') in gastric parietal cells.
This action blocks the final step in acid production, making PPIs highly effective for conditions like GERD, peptic ulcers, and Zollinger-Ellison syndrome.

Option A: Ranitidine is not a PPI. It is classified as a histamine-2 (H₂) receptor antagonist.
Option B: Famotidine is also an H₂ receptor antagonist, similar to ranitidine. It works by blocking histamine receptors, not the proton pump.
Option D: Sucralfate is a mucosal protective agent. It forms a physical barrier over ulcers to protect them from acid but does not inhibit acid production.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological classification of acid-suppressing drugs as background academic context rather than a clinical decision trigger.
Nurses must educate patients to take PPIs like pantoprazole 30-60 minutes before the first meal of the day for maximal effectiveness, as the pumps are most active after a period of fasting.
Long-term use of PPIs is associated with risks such as osteoporosis-related fractures, C. difficile infection, pneumonia, and deficiencies in magnesium and vitamin B₁₂. Nurses should monitor for these complications in patients on chronic therapy.
What if the patient cannot swallow the pantoprazole tablet? The nurse should not crush the delayed-release tablet. Instead, they should consult the pharmacist or prescriber about alternative formulations, such as granules for oral suspension or an intravenous (IV) form, if available and appropriate.

How to Approach the Question

First, identify the core of the question, which is to find the drug belonging to the 'proton pump inhibitor' (PPI) class.
Second, systematically review each option and recall its pharmacological classification.
For Option A (Ranitidine) and B (Famotidine), recognize them as H₂ receptor antagonists.
For Option C (Pantoprazole), identify the '-prazole' suffix, which is a common indicator for most PPIs.
For Option D (Sucralfate), recall its unique mechanism as a mucosal protectant that coats ulcers.
Finally, select Pantoprazole as it is the only drug in the list that fits the PPI classification.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 3 pp. 169-171, 168-170

E6 Pharmacology Katzung 16e p. 1732-1734

Practise the full AIIMS Patna NO - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.