Some studies show that after a period as short as 1 week, the acid reducing properties of H 2 RAs begin to decline thereby necessitating higher doses for the same degree of acid blockade. False The effects of PPIs are rendered after systemic absorption in the small intestine. The drug passes from the blood into the parietal cell, and from there it is released into the cannaliculi of the parietal cell. In this extracellular position in the gastric lumen, the drug can bind active ATPase pumps and inhibit acid release. The optimal time to take PPIs is on an empty stomach shortly before eating a meal.
Acid production is maximized around mealtime because of the different stimuli to the parietal cell.
If the medication is ingested on an empty stomach, it can be absorbed and concentrate around the parietal cell before any pumps are activated. Recently it was found that there is an association between infection with H. pylori and degree of acid suppression. It appears that gastric H. pylori infection can potentiate the effects of PPIs, allowing for greater acid suppression. False Even though the acid suppression provided by the PPIs is long acting, some patients may require more frequent dosing. Prescribing the medication in split doses, once in the morning before breakfast and once in the evening before dinner, optimizes the effect of the medication when compared to once daily dosing.