PPIs are weak bases activated by protonation in parietal cells

That's right! PPIs are weak bases, which become protonated in the acidic environment of the stomach, thus becoming active. This also results in the drugs becoming entrapped in parietal cells, which restricts their action locally.  

A few weeks later 

Mr. Mason has finished his H. pylori eradication regimen but continues to take the PPI to allow for ulcer healing.  

On Sunday morning, the Masons are getting ready to go to church. It is a cold, winter morning and it has been snowing for the best part of the night. Mr. Mason is walking to his car, when he slips on a patch of ice and falls on the staircase. In addition to his bruised ego, Mr. Mason is in a lot of pain and is clutching his arm. 

Mrs. Mason takes him to the hospital, where a humerus fracture is diagnosed. 

An adverse effect due to which drug could have contributed to Mr. Mason's fracture risk?



Lansoprazole
Metolazone
Bisoprolol
Amoxicillin
Ramipril

Map: Connor Mason_UNIC (1100)
Node: 20908
Score:

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  • Ask rapid questions using medical jargon (ischemia, necrotic tissue, perfusion).
  • Ursodeoxycholic acid
  • Hyoscine
  • Sterculia
  • Lactulose
  • Mechanism of action of PPIs
  • Ignore the wound complaint and focus solely on blood glucose.
  • Privacy risk
  • B
  • PPIs are weak bases that become activated by colonic bacteria
  • D
  • C
  • Ignore the emotional expression.
  • E
  • A
  • Respond bluntly: “That is common in diabetes.”
  • PPIs are weak acids activated by protonation in parietal cells
  • Blame the patient for non-adherence
  • PPIs are weak bases converted by CYP450 enzymes to the active form in parietal cells
  • Validate the emotion
  • Sequesters bile acids
  • PPIs are weak acids converted by CYP450 enzymes to the active form in parietal cells
  • Antagonizes beta receptors
  • Activates vasopressin receptors
  • Activates somatostatin receptors
  • PPIs are weak bases activated by protonation in parietal cells

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